SERRATUS ANTERIOR FREE-TISSUE TRANSFER - HARVEST-RELATED MORBIDITY IN34 CONSECUTIVE CASES AND A REVIEW OF THE LITERATURE

Donor-site morbidity in serratus anterior free-tissue transfers is inv estigated in 34 consecutive cases. Nineteen lower-extremity reconstruc tions and 15 facial reconstructions were retrospectively analyzed. Off ice and hospital charts were reviewed, and patients were given a follo w-up questionnaire. The mean operative time was 6.3 hr and the mean es timated blood loss was 441 cc. Transfusion was required in 24 percent of cases. The early complication rate was 21 percent consisting of 6 p ercent hematomas and 15 percent seromas. Scar appearance, pain, numbne ss, and shoulder strength and mobility were acceptable. Scapular wingi ng was detectable in 3/9 patients examined, but symptomatic in only on e. The number of muscle slips harvested or whether the graft was inner vated did not significantly affect this rate. Half of the patients had returned to work or school. None attributed any work disability to th eir donor sites. They participated in many athletic activities, includ ing those requiring upper extremity strength and dexterity. Previously reported series are discussed, and the morbidity of this donor site i s compared with reported series of other free muscle flaps. The author s find this flap useful for facial reanimation and for soft-tissue cov erage with minimal bulk. Low rates of operative, perioperative, and lo ng-term morbidity are definite advantages.