Vol. 8, Issue 1, Part B (2024)

Background: Reconstructing the soft tissue defects caused by trauma in the extremities remains a challenging procedure in reconstructive surgery. The present work aimed at evaluating the versatility of scapular and parascapular free flaps in limb soft tissue defects reconstruction. 

Methods: This work was a prospective study, conducted on 30 cases with clinical criteria of traumatic soft tissue defects of the extremity and defects after removal of scar contracture at upper or lower limb. 

Results: Reconstruction was performed to 27 patients using para-scapular free flaps (90%) and the other 3 patients were reconstructed by scapular free flaps (10%). The length of the flaps ranged from 13-38 cm (mean: 27.3±3.1cm), the width of the flaps ranged from 6-12 cm (mean: 7.4±1.7 cm). The flap thickness ranged from 7-14 mm (mean 8.5±1.3 mm). The vascular pedicles length ranged from 3-5 cm (mean 4±0.6 cm). The operative time for the scapular and para-scapular free flaps was ranged from 250-550 minutes (mean: 290±39.4).

Conclusions: The scapular and parascapular flaps are a multipurpose alternate in reconstructing soft tissue of the upper & lower extremities, that might be utilized for various indications in properly selected cases. These flaps should be ones of cornerstone flaps in reconstructing soft tissue defect of the upper and lower limbs reconstruction since it has numerous advantages and versatility as reliable blood supply, thin (No need for further debulking), large coverage area, and less donor-site morbidity to provide the required functional and aesthetic outcomes. Finally, the decision concerning the best method for reconstruction requiring free flaps is better to be individualized according to patient’s factors as well as the experience of the surgeon.