[Clinical application of the scapular free flap extended to the upper arm].
OBJECTIVE
To apply the scapular free flap extended to the upper arm for resurfacing the face and neck, as well as the upper lip in one stage.


METHODS
The scapular free flap was designed with extended portion to the posterior and interior part of the upper arm. Then the free flap was transferred to resurface the face and neck with the routine portion and to resurface the upper lip with the extended portion.


RESULTS
6 cases with extensive upper lip, facial and cervical burn scar were treated with the extended scapular free flaps. The flap size ranged from 22 cm x 11 cm to 40 cm x 9.5 cm (36.57 cm x 10.20 cm in average) for the routine portion and from 7 cm x 4 cm to 12 cm x 4 cm (10.32 cm x 3.67 cm in average) for the extended portion. All flaps survived completely.


CONCLUSIONS
There are direct communicating branches ("choke vessel") between the circumflex scapular artery (CSA) and the posterior humeral circumflex artery (PHCA). When the blood supply of PHCA is cut off, the CSA can provide blood supply through the communicating branches to the upper arm skin area previously nourished by PHCA. So the blood supply of the extended portion of the scapular free flap is not only from the branches of CSA, but also from the direct communicating branches between the CSA and PHCA. The extended scapular free flap has a reliable blood supply and can be applied to construct the facial and cervical scar contraction with the extended portion to resurface the upper lip. The satisfactory result can be expected.
Liu
Yuan-Bo
YB
Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing 100144, China.
Fan
Jin-Cai
JC
Jiao
Peng
P
Tang
Xin
X
Liu
Li-Qiang
LQ
Wang
Qian
Q
Tian
Jia
J
Gan
Cheng
C
Yang
Zeng-Jie
ZJ
Zhang
Zhuo-Nan
ZN
Chen
Yu-Gang
YG
D000328:Adult; D001132:Arm / Q000601:surgery; D002921:Cicatrix / Q000601:surgery*; D006801:Humans; D008297:Male; D009333:Neck; D012540:Scapula; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D055815:Young Adult