title: Consecutive flap transfer for repairing massive soft tissue defects in the opisthenar with improved donor site closure.
abstract: OBJECTIVE
  To explore a surgical model of utilizing consecutive free scapular flap and adjacent pedicled flap transfer for repairing massive soft tissue defects on the dorsum of the hand while minimizing the donor site morbidity.
  
  
  METHODS
  Six patients with massive soft tissue injuries on the opisthenar and forearm were treated with free scapular flaps. Afterwards, a pedicled flap adjacent to the donor site was transferred to cover the donor site defect by direct closure.
  
  
  RESULTS
  All six free scapular flaps survived without signs of infection. Three adjacent pedicled flaps presented minor signs of insufficient blood flow on the distal apex, which resolved after six weeks with only conservative therapy. All the incisions healed without other complications. At six-month follow-up, the patients regained full shoulder function.
  
  
  CONCLUSIONS
  With the assistance of an adjacent pedicled flap, the scapular flap is a highly applicable approach in repairing massive soft tissue defects in the opisthenar. It can achieve positive outcomes in both reconstructive and aesthetic aspects.
authors.affiliation: Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100730, China.
authors.forename: Lehao
authors.initials: L
authors.lastname: Wu
authors.forename: Dedi
authors.initials: D
authors.lastname: Tong
authors.forename: Shan
authors.initials: S
authors.lastname: Zhu
authors.forename: Mengqing
authors.initials: M
authors.lastname: Zang
authors.forename: Guanglei
authors.initials: G
authors.lastname: Tian
authors.forename: Shanlin
authors.initials: S
authors.lastname: Chen
mesh_terms: D000328:Adult; D001134:Arm Injuries / Q000601:surgery*; D003646:Debridement; D004322:Drainage; D005260:Female; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012540:Scapula / Q000098:blood supply*; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*; D016896:Treatment Outcome