The free serratus anterior flap and its cutaneous component for face reconstruction: a series of 27 cases |
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Authors: | B Pittet A L Mahajan N Alizadeh K-U Schlaudraff J Fasel D Montandon |
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Institution: | (1) Department of Plastic and Reconstructive Surgery, University Hospitals of Geneva, Geneva, Switzerland;(2) Department of Morphology, University of Geneva Medical Centre, Geneva, Switzerland |
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Abstract: | SUMMARY The serratus anterior flap is commonly used without its cutaneous component and is covered with a skin graft. We have successfully
used the free serratus anterior flap along with its skin paddle and have found it to be valuable for reconstruction of the
face. We have done fresh cadaveric dissections and arteriography to identify perforator vessels to the skin overlying the
muscle. Clinically, free transfer of the musculocutaneous flap to the face was carried out in 27 patients, mostly for severe
noma (infection) sequellae. Anatomical dissection and arteriography revealed no cutaneous perforator vessels directly communicating
with the vascular pedicle of the muscle. However, large perforators from the intercostal vessels were found passing through
the muscle to reach the skin. In the clinical cases, flap survival was 100% in 24 patients. The serratus anterior musculocutaneous
flap is reliable and particularly well-suited for reconstruction of the face with many advantages. We speculate that the skin
paddle may be vascularised by perforators from the intercostal vessels communicating with the thoracodorsal pedicle through
intramuscular choke vessels.
Authors' address: B. Pittet, Div. Plastic and Reconstructive Surgery, University Cantonal Hospital, Rue Micheli-du-Crest 24,
1211 Geneve 14, Switzerland |
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Keywords: | Free flap Musculocutaneous Myocutaneous Craniofacial reconstruction Face reconstruction Noma sequellae |
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