title: The scapular osteofasciocutaneous flap: a 12-year experience.
abstract: OBJECTIVE
  To elucidate the factors that play a role in the decision-making process to use the scapular donor site, we have reviewed our 15-year experience with 57 clinical cases, to our knowledge the largest case series to date.
  
  
  METHODS
  Retrospective, single-surgeon medical record review.
  
  
  METHODS
  Retrospective review of 57 consecutive cases (53 patients) involving mandibular and maxillary reconstruction using bone-containing scapular free flaps over a 15-year period. Composite flap composition as well as donor and recipient site complications were recorded.
  
  
  RESULTS
  Forty-one reconstructions were performed for mandibular defects, 11 were performed for maxillary defects, and 5 for combined defects involving the mandible and maxilla. Seven flaps were composed of 2 separate bone flaps using the angular branch and the circumflex scapular artery. A total of 6 flaps were failures in 5 patients, giving an overall success rate of 89%.
  
  
  CONCLUSIONS
  The subscapular system of flaps is a versatile donor site that offers distinct advantages in the older patient population as well as in patients with a preexisting gait disturbance. It is particularly advantageous in patients requiring a large surface area of soft tissue to restore their defect.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, NY 10029, USA. mark.urken@mssm.edu
authors.forename: M L
authors.initials: ML
authors.lastname: Urken
authors.forename: A G
authors.initials: AG
authors.lastname: Bridger
authors.forename: K B
authors.initials: KB
authors.lastname: Zur
authors.forename: E M
authors.initials: EM
authors.lastname: Genden
mesh_terms: D000368:Aged; D016025:Bone Transplantation; D002280:Basal Cell Carcinoma / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008339:Mandibular Neoplasms / Q000601:surgery*; D008441:Maxillary Neoplasms / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011788:Quality of Life; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome