title: Facial reconstruction using a combined flap of the subscapular axis simultaneously including separate medial and lateral scapular vascularized bone grafts.
abstract: With the better understanding of the blood supply to the scapula, combined flaps of the lateral scapula along with the latissimus dorsi and/or serratus anterior are well known. The medial border of the scapula, in this respect, has been underused. The authors present a case report in which a conjoined combined free flap consisting of four free tissue transfers based on the subscapular axis was used in simultaneous reconstruction of a gunshot wound to the face. This included a medial scapular osteofasciocutaneous flap for the mandible, a lateral scapular osseous flap for the anterior maxilla, a serratus anterior muscle flap for the cheek, and a separate latissimus dorsi musculocutaneous flap for the forehead. This flap was successful and provides another alternative to the resolution of complex problems needing multiple areas of both soft-tissue coverage and vascularized bone graft.
authors.affiliation: Lehigh Valley Hospital and Health Network, Allentown, PA 18105-1556, USA.
authors.forename: Grant A
authors.initials: GA
authors.lastname: Fairbanks
authors.forename: Geoffrey G
authors.initials: GG
authors.lastname: Hallock
mesh_terms: D016025:Bone Transplantation / Q000379:methods*; D005151:Facial Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*; D016896:Treatment Outcome; D014945:Wound Healing; D014948:Wounds, Gunshot / Q000601:surgery*