title: Subscapular system of flaps: An 8-year experience with 105 patients.
abstract: BACKGROUND
  Review patient and defect factors in which this donor site is an optimal choice for reconstruction and to discuss strategies to overcome the perceived drawbacks of this system of flaps.
  
  
  METHODS
  A retrospective medical chart review was conducted on all patients who underwent the subscapular system of free flaps for head and neck reconstruction.
  
  
  RESULTS
  Ninety-eight reconstructions were performed for mandibular defects, 4 for maxillary defects alone and 3 for combined mandible-maxilla defects. The overall success rate was 98%.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Montefiore Green Medical Arts Pavilion, Bronx, New York.
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Gibber
authors.affiliation: Thyroid Head and Neck Cancer Foundation, Department of Head and Neck Oncology, New York, New York.
authors.forename: Jason B
authors.initials: JB
authors.lastname: Clain
authors.affiliation: Department of Head and Neck Surgery, Beth Israel Medical Center, New York, New York.
authors.forename: Adam S
authors.initials: AS
authors.lastname: Jacobson
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Beth Israel Medical Center, New York, New York.
authors.forename: Daniel
authors.initials: D
authors.lastname: Buchbinder
authors.affiliation: Thyroid Head and Neck Cancer Foundation, Department of Head and Neck Oncology, New York, New York.
authors.forename: Sophie
authors.initials: S
authors.lastname: Scherl
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Jose P
authors.initials: JP
authors.lastname: Zevallos
authors.affiliation: Department of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Saral
authors.initials: S
authors.lastname: Mehra
authors.affiliation: Department of Otolaryngology, Beth Israel Medical Center, New York, New York.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Urken
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation / Q000379:methods; D005260:Female; D058752:Free Tissue Flaps / Q000637:transplantation*; D006801:Humans; D008297:Male; D008339:Mandibular Neoplasms / Q000601:surgery*; D008441:Maxillary Neoplasms / Q000601:surgery*; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D012540:Scapula / Q000601:surgery*; D016896:Treatment Outcome
keywords: mandibular reconstruction; maxillary reconstruction; osteocutaneous and fasciocutaneous flaps; scapular flap; subscapular vessels