DELAYED INSET OF PARASCAPULAR FASCIOCUTANEOUS FREE FLAP, AS A WISE TECHNIQUE FOR RECONSTRUCTION OF SPEFICIC SOFT TISSUE DEFECTS

Aim: The aim of this study is to elaborate the concept of delayed inset of free parascapular flap over ertain soft tissue defects in head and neck and lower limbs. The final inset is usually done 5-7 days following the main microsurgical operation after being sure of flap survival. Methods: Twelve patients (9 males, 3 females), patient age range 12 to 58 years were treated with free fasciocutaneous parascapular flaps from the period from January 2007 to January 2010. The soft tissue defects were 4 in the head and neck region and 8 cases in middle and distal third of the leg. Results and Conclusion: In all the twelve flaps the concept of delayed inset of the flap was applied, and final inset was achieved after 5-7 days after the first microsurgical operation. The time of the first operation was reduced (average time was 3-5 hours). The second operation time was between 70 minutes -100 minutes. The delayed inset of the parascapular flap prevents exposure of important structures that could occur if debridement around the recipient defect is done and then partial or total flap loss occurs, it also avoids the blood loss that results from excision and preparation of the area around the recipient defect. This blood loss if added to the blood loss of the flap dissection and microsurgical anastomosis may affect the healing power of the flap