Objective: A large defect needs a large flap to repair. This clinical study was to explore the possibility and safeness of transferring the extended scapular free flap.
Method: We have used the transverse scapular flap to reconstruct large defects in the mandibular or cervical region in 8 patients. The flap was designed to cross the midline of the back as far as 15 cm. The largest flap measured 31 x 34 cm.
Results: Of the 8 flaps, six survived completely; local epidermal necrosis appeared in two.
Conclusion: The free scapular flap supplied by a single circumflex scapular vascular pedicle can be safely extended beyond the midline of the back. The flap axis is the horizontal branch of the circumflex scapular vessel.