Reconstruction of soft-tissue defects using serratus anterior adipofascialfree flap

The serratus anterior muscle has been suggested as a versatile and reliable flap for reconstruction of head and neck and extremity injuries. The adipo fascial layer over lying the serratus anterior muscle is the anatomic layer , which is supplied by the same branch of thoracodorsal artery. Even though great progress has occurred in the prevention of postoperative adhesion of extremity injuries, the problem has not been completely solved and is still of special importance in complex injuries. Between March of 19 95 and February of 1996, seven patients underwent reconstructive operation as a result of soft-tissue defects of the upper or lower extremities or the scalp. We transferred free adipofascial tissue overlying the serratus ante rior muscle in three patients and both serratus anterior muscle and adipofa scial tissue in four patients. A free adipofascial flap overlying serratus anterior muscle was transferred when a gliding surface was required, owing to the exposure of tendons and neurovascular structures. The average duration from operation to follow-up examination was 8 months ( from 4 to 16 months). The results of the operations were satisfactory in fu nctional and cosmetic aspects. This kind of flap was very effective in reco nstruction of soft-tissue defects and Sliding surfaces for these reasons: e asy dissection, the capability of obtaining a long vascular pedicle, large- sized flap, composite flap including muscle or rib, and the fact that there was no serious functional or cosmetic deficit at the donor site.