Serratus anterior free fascial flap for dorsal hand coverage

Reconstruction of the dorsal surface of hand defects requires thin, pliable , well-vascularized tissue with a gliding surface for the extensor tendon c ourse. Fasciocutaneous or fascial flaps are the two surgical options. Fasci al flaps present the advantages of thinness and low donor site morbidity, T he authors present 4 cases of serratus anterior free fascial flap (SAFFF) u sed to cover the dorsum of the hand, The SAFFF with skin graft has many adv antages for a fascial flap: long, constant vascular pedicle; very thin, wel l-vascularized tissue; low donor site morbidity; and the possibility of sim ultaneous donor and recipient site dissection. Furthermore, it can be assoc iated with other flaps of the subscapular system for complex reconstruction s. Of the 4 observations described, 2 used associated flaps, 1 used the SAF FF with a latissimus dorsi flap, and 1 used a scapular bone flap with the S AFFF. One flap was lost due to an electrical lesion to the forearm vessels.