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견갑하 혈관경을 기저로 하는 키메라 피판의 유용성Usefullness of Chimeric Flaps Based on the Subscapular Vascular System

Other Titles
Usefullness of Chimeric Flaps Based on the Subscapular Vascular System
Authors
김현석박승하이병일임형우
Issue Date
2009
Publisher
대한성형외과학회
Keywords
Chimeric flap; Subscapular vascular system
Citation
Archives of Plastic Surgery, v.36, no.5, pp.597 - 604
Indexed
KCI
Journal Title
Archives of Plastic Surgery
Volume
36
Number
5
Start Page
597
End Page
604
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/121743
ISSN
2234-6163
Abstract
Purpose: Compound tissue defects remain a challenge to reconstructive surgeons. The objective of this study was to introduce examples of successful reconstruction of compound defects of the head and neck and upper and lower limbs, using chimeric flaps based on the subscapular vascular system. Methods: We report 19 reconstruction cases using chimeric flaps based on the subscapular vascular system. The scapular flap, scapular fascia, scapular bone, parascapular flap, latissimus dorsi, latissimus dorsi perforator flap, latissimus dorsi myocutaneous perforator flap, serratus anterior, serratus anterior fascia, and rib bone were used as components for chimeric flaps. 12 cases had defects of the upper limb, three in the lower limb, three in the head and neck area, and one case had a defect of the thoracoabdominal wall. Results: Defect sizes ranged from 6 × 8 ㎝ to 20 × 22 ㎝. The component used most often for skin coverage was the latissimus dorsi perforator flap; for soft tissue bulk, the latissimus dorsi; for fascia coverage, the serratus anterior fascia flap; and for bone reconstruction, the scapular bone flap respectively. All cases were successfully reconstructed without additional operative procedures or flap necrosis. Conclusion: Because it is fairly easy to employ vascular pedicles of sufficient length and diameter, enabling the use of diverse types of tissue with various shapes and sizes, the use of chimeric flaps based on the subscapular vascular system allows one - stage reconstruction tailored to the characteristics of the defect area.
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