Subscapular system of flaps: An 8‐year experience with 105 patients

Abstract

The subscapular system of free flaps is an excellent option in patients for whom the alternative donor sites are either not usable or lack the associated soft tissue elements required for a successful reconstruction. This flap should also be considered as a first choice for patients with complex/extensive surgical defects requiring multiple, independently mobile, soft tissue components; in patients who will benefit from a large muscle flap placed over the vital structures in the neck; patients of advanced age; and patients in whom early mobilization is critical.

Predictors of plate extrusion in oromandibular free flap reconstruction

“…Several authors have noted that hardware exposure occurred at a higher rate in patients who underwent osseocutaneous radial forearm free flaps (OCRFFF) versus fibular free flaps (FFF), and concluded that this was likely due to the smaller amount of soft tissue incorporated in the OCRFFF (Day et al, ; Dean et al, ; Virgin et al, ). The subscapular system of free flaps makes available considerable soft tissue bulk with excellent mobility of the soft tissue relative to the bony component and generally provides abundant soft tissue coverage of the reconstruction plate (Gibber et al, ; Urken et al, ; Yoo et al, ).…”

“…Segmental mandibular defects following composite oromandibular resections require complex reconstructions to maintain mandibular continuity to rehabilitate mastication, swallowing, articulation, oral competence, and aesthetics. Osseocutaneous free tissue transfer with titanium plate fixation is the gold standard for oromandibular reconstruction (Bak et al, 2010;Hanasono, 2014) with FFF (Cordeiro, Disa, Hidalgo, & Hu, 1999;Hidalgo & Pusic, 2002), subscapular system of free flaps (Gibber et al, 2015;Urken et al, 2001;Yoo et al, 2013), iliac crest free flaps (Safak, Klebuc, Mavili, & Shenaq, 1997), and radial artery forearm osseous free flap (Arganbright et al, 2013;Day et al, 2014;Thoma et al, 1999) being the contemporary options.…”

Shouldering the load of mandible reconstruction: 81 cases of oromandibular reconstruction with the scapular tip free flap

“…The versatility, abundance of soft tissue, and complete freedom from the bone are major advantages of the STFF as compared with other bone flaps (Figure ). Therefore, the STFF may be especially valuable in restoring segmental mandibular resections where soft‐tissue reconstruction has high priority …”

“…The bone obtained from the scapula can support dental implantation . Moscoso et al concluded that the lateral border scapula bone ranked second to the iliac crest for the reliability of the bone stock and suitability for dental implantation .…”

Association of the Anterolateral Thigh Osteomyocutaneous Flap With Femur Structural Integrity and Assessment of Prophylactic Fixation

“…Some advocate for the use of flaps based on the subscapular system, while others prefer a 2-flap approach in this setting. 1–4 Drawbacks of these options include challenges raising subscapular system flaps concurrently with tumor ablation and increased operative times. 2,3 …”