COMBINED V-FIGURE-SHAPED SCAPULAR OSTEOCUTANEOUS AND LATISSIMUS-DORSIMYOCUTANEOUS FLAP FOR COMPOSITE MANDIBULAR RECONSTRUCTION

Background. As early as 1981, the scapular crest was reported as a ver satile donor site of vascularized bone flap. In our institute, much at tention has been paid to applying a compound flap based on the subscap ular vascular system for composite mandibular reconstruction. Methods. The combined V figure-shaped scapular osteocutaneous and latissimus d orsi myocutaneous flap has been used for primary or secondary reconstr uction of the mandible, intraoral mucosa and/or external skin followin g major ablation of the malignant tumors in seven patients. Results. T here was one total flap failure. Satisfactory results were obtained in the remaining patients. Conclusions. The V figure-shaped scapular bon e flap supplied by the angular branch provides a long rotation arc of vascular pedicle, a long bony segment of more than 14 cm, and a good c ontour of mental protuberance. The combination of the scapular osteocu taneous flap with latissimus dorsi myocutaneous flap allows reliable r econstruction of massive and three-dimensional composite mandibular de fects. (C) 1995 John Wiley and Sons, Inc.