Serratus anterior free flap: A personal series and meta-analysis review

Abstract

Serratus anterior muscle free flap is a versatile flap used for various microsurgical reconstructive procedures, especially when the amount of needed muscle is limited. Reviewing retrospectively our own series of 12 patients (13 flaps), we made an extensive review of the medical literature in order to proceed to a meta-analysis concerning that flap. The serratus anterior flap was used for reconstruction of eight lower limbs, three head and neck, and one abdominal soft tissue defects. The etiology of the tissue defect was trauma in four cases, cancer in five cases and complications of other surgical procedures in three cases.The meta-analysis did not show any specific occurrence or association relative to this flap and just reveals geographical differences concerning the indications, the type of flap, and sex ratio from a continent to another. We consider this flap a very effective and useful tool in the daily armamentarium of the microsurgeon. The main advantage of this flap is the possibility to design a reliable small muscular free flap, with only one muscular digitation. Uses are many and various: trauma or post-trauma, cancers, vascular deformities or diseases, facial paralysis, and osteomyelitis. Level of Evidence: Level IV, therapeutic study