Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-26T15:26:17.758Z Has data issue: false hasContentIssue false
  • English
  • Français

‘Sit and tilt’ preparation for subscapular system free flaps

Published online by Cambridge University Press:  16 January 2018

J Mark ,
H Patwa ,
M S Costello  and
Y Patil
J Mark
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, University of Cincinnati College of Medicine, Ohio, USA
H Patwa
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, University of Cincinnati College of Medicine, Ohio, USA
M S Costello
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Medical University of South Carolina, Charleston, USA
Y Patil*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, University of Cincinnati College of Medicine, Ohio, USA
*
Address for correspondence: Dr Yash Patil, Department of Otolaryngology – Head and Neck Surgery, University of Cincinnati College of Medicine, ML 0528, Cincinnati, Ohio, USA Fax: +1 (513) 558 5203 E-mail: yash.patil@uc.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

The ablation of advanced head and neck cancer often results in large three-dimensional defects that require free tissue transfer to optimally address functional and cosmetic issues. The subscapular system is a highly versatile donor site for flaps used for head and neck reconstruction. Traditional methods of harvesting subscapular flaps require repositioning and re-preparing, which significantly increases the operative time and prevents simultaneous harvesting of the flap.

Method:

This paper presents our experience of a single-stage ‘sit and tilt’ technique, which provides a convenient method for harvesting subscapular system free flaps without significant repositioning.

Results and conclusion:

This technique was used for a variety of head and neck defects, and body habitus did not seem to affect free tissue harvesting. It is hoped that utilisation of this preparation and harvesting technique will make head and neck surgeons more willing to take advantage of the subscapular system.

Keywords

Free Tissue FlapsHead And Neck NeoplasmsReconstructive Surgical ProceduresPosture
Type
Short Communication
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 2 , February 2018 , pp. 180 - 183
Copyright
Copyright © JLO (1984) Limited 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Urken, ML. Multidisciplinary Head & Neck Reconstruction: A Defect-Oriented Approach. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2010 Google Scholar
2 Fisher, D, Patel, R, Izzard, M. Subscapular system flaps. In: Kountakis, SE, ed. Encyclopedia of Otolaryngology, Head and Neck Surgery. Berlin, Heidelberg: Springer, 2013;2599–607CrossRefGoogle Scholar
3 Chiaramonte, MF, Nahabedian, MY. Bilateral breast reconstruction with the latissimus dorsi musculocutaneous flap: the importance of patient positioning. Ann Plast Surg 2001;46:163–6Google Scholar
4 Gibber, MJ, Clain, JB, Jacobson, AS, Buchbinder, D, Scherl, S, Zevallos, JP et al. Subscapular system of flaps: an 8-year experience with 105 patients. Head Neck 2015;37:1200–6CrossRefGoogle ScholarPubMed
5 Sumner, SA, Fox, S. Latissimus dorsi myocutaneous flap. In: Guyuron, B, Eriksson, E, Persing, J, eds. Plastic Surgery: Indications and Practice. Philadelphia: Saunders, Elsevier, 2008;271–80Google Scholar
6 O'Connell, MP. Positioning impact on the surgical patient. Nurs Clin North Am 2006;41:173–92Google Scholar
7 Baj, A, Capparé, P, Autelitano, L, De Riu, G, Beltramini, GA, Segna, E et al. The park-bench position in cervico-facial reconstructive surgery: a technical note. Acta Otorhinolaryngol Ital 2013;33:129–32Google Scholar
8 Paek, LS, Boa, O, Revol, M, Servant, JM, Harris, PG, Danino, AM. A new dorsal decubitus position for raising subscapular-based flaps. J Plast Reconstr Aesthet Surg 2012;65:e60–3 Google Scholar
9 Paek, LS, Boa, O, Revol, M, Servant, JM, Harris, PG, Danino, MA. A review of 105 subscapular-based flaps harvested using a new dorsal decubitus position: how far can we go? Eplasty 2013;13:e10 Google ScholarPubMed
10 Albin, M, Babinski, M, Maroon, JC, Jannetta, PJ. Anesthetic management of posterior fossa surgery in the sitting position. Acta Anaesthesiol Scand 1976;20:117–28CrossRefGoogle Scholar
11 Sekhar, LN, Tzortzidis, F, Bucur, SD. Patient positioning for cranial microsurgery. In: Sekhar, LN, Oliveira, ED, eds. Cranial Microsurgery, Approaches and Techniques, Vol 1. New York: Thieme, 1999;12–18 Google Scholar
12 Har-El, G, Bhaya, M, Sundaram, K. Latissimus dorsi myocutaneous flap for secondary head and neck reconstruction. Am J Otolaryngol 1999;20:287–93Google Scholar
13 Schuller, DE. Latissimus dorsi myocutaneous flap for massive facial defects. Arch Otolaryngol 1982;108:414–17Google Scholar
14 Quillen, CG, Shearin, JC Jr, Georgiade, NG. Use of the latissimus dorsi myocutaneous island flap for reconstruction in the head and neck area: case report. Plast Reconstr Surg 1978;62:113–17Google Scholar
15 Pohlenz, P, Klatt, J, Schon, G, Blessmann, M, Li, L, Schmelzle, R. Microvascular free flaps in head and neck surgery: complications and outcome of 1000 flaps. Int J Oral Maxillofac Surg 2012;41:739–43Google Scholar