Microsurgical combined scapular/parascapular flap for reconstruction of severe neck contracture: Case report and literature review

Objective: The reconstruction for severe neck contracture is difficult, bec ause it may include not only the necessity the use of a large flap but also the ability for three-dimensional movement of the neck. Methods: A 41-year-old woman sustained a severe neck contracture with retra ction of the lower lip and limited range of neck motion after a chemical bu rn. We used the combined scapular/parascapular nap to reconstruct the soft- tissue defect in the neck after excision of hypertrophic scar and release o f contracture. The scapular portion was transferred to cover the defect ver tically, and the parascapular portion was transferred to cover the transver se portion of the neck. This kind of design would allow the patient to move her neck more easily. Results: Postoperatively, the range of motion of the neck was full in the v ertical and horizontal directions after 6 months of rehabilitation. Also, t he patient was satisfied with the final aesthetic results. Conclusion: The microsurgical combined scapular/parascapular flap, providin g a large area of tissue for coverage in three dimensions with a reliable b lood supply by only one pedicle anastomosis during surgery, is a good optio n for reconstruction of the severe neck contracture. We classify the inset of the combined scapular/parascapular flap into three types with six subtyp es, according to the location of defects and the relation of the parascapul ar flap to the scapular flap.