Reconstruction of complex shallow defects of the extremities with musculofascial serratus anterior free flap

Abstract

Background/aim Thin and flexible flaps are needed for the repair of extremity tissue defects. Serratus fascia flaps are the most suitable options. There are only a few case reports and case series in the literature. We have aimed to increase the success rate by taking the serratus fascia flaps together with some muscle tissue for the repair of extremity tissue defects. Materials and methodsBetween 2006 and 2015, 12 free serratus musculofascial flaps (FSMFFs) were transferred to 11 patients (8 males, 3 females) who had tissue shallow defects of the extremities due to different etiologic factors. The mean age was 24.6 years. Hospital records and patient photographs were reviewed and age, sex, etiologic cause, follow-up period, complication, flap success, cosmetic appearance, and functional results of the extremity were examined.Results The mean follow-up period was 29.5 months (7–109 months). All of the flaps survived fully and no partial or full necrosis was observed. Partial graft loss was encountered in one patient and it was recovered secondarily with wound dressing. A major deficiency was not experienced postoperatively in the functions and movements of the extremities retained. The cosmetic appearance of the operation area was acceptable or fine. The donor areas healed in all the patients without any problems, and the scars were hidden and inconspicuous.Conclusion In reconstruction of complex shallow defects of the extremities in which a gliding effect is desired, FSMFF may be an ideal option with its advantages as it does not sacrifice a major vessel, does not leave a hidden and short scar, can be harvested in wide dimensions, and allows the use of the surrounding tissues such as the latissimus dorsi muscle and scapular bone.