Retalho Duoescapular: uma nova opção na cirurgia reparadora do ombro / Duoscapular flap: a new option in shoulder reconstructive surgery

INTRODUÇÃO: O Dermatofibrossarcoma do Ombro é patologia incomum e seu tratamento demanda extensas ressecções. O sistema escapular é fonte de retalhos bastante utilizados nesta região. MÉTODO: Realizado estudo longitudinal, prospectivo, através da condução de um caso de Dermatofibrossarcoma Protuberans em ombro direito, submetido a ressecção e reconstrução local com Retalho Duoescapular, obtido através da associação dos retalhos escapular e paraescapular. RESULTADOS: Paciente evoluiu sem intercorrências no pós-operatório, não sendo observadas complicações sistêmicas e locais, e limitações funcionais. CONCLUSÃO: O Retalho Duoescapular é nova e relevante opção para reconstrução de feridas extensas, com exposição de estruturas nobres no ombro. Permite fechamento primário da área doadora, sem acrescentar morbidade ao procedimento.

INTRODUCTION: Shoulder cutaneous fibrosarcoma is an unusual pathology that requires extensive resections. The scapula is a source of flaps widely used in this region. METHOD: A longitudinal and prospective study was carried out in a patient with protuberans cutaneous fibrosarcoma on the right shoulder who underwent resection followed by local reconstruction with a Duoscapular Flap (a combination of scapular and parascapular flaps). RESULTS: The patient had no postoperative complications, as systemic and local complications as well as functional limitations were not observed. CONCLUSION: Duoscapular Flap placement is a novel procedure and a relevant choice for the reconstruction of extensive wounds exposing noble structures in the shoulder. It allows the primary closure of the donor area without increasing the morbidity of the procedure.

Removal of a T1-2 Neurilemmoma by Lateral Parascapular Extrapleural Approach

The authors report a case of T1-2 neurilemmoma removed by lateral parascapular extrapleural approach. A 28-year-old man was presented with smooth, well-marginated radiopaque mass in left superior mediastinum on plain chest X-ray. Magnetic resonance imaging revealed a sharply marginated isosignal lesion in the left thoracic inlet on T1 weighted image and strong enhancement on T1 enhanced image. A 15cm length hockey stick skin incision was made from C7 to T9 level. A 2x3cm sized orange colored soft tissue mass was detected over the pleura. The intercostal nerve, subclavian artery, and internal carotid artery were adherent with mass. After gentle dissection, the tumor was removed from nerve bundle. Pathologic examination of tumor revealed a neurilemmoma. The patient was discharged 3 weeks after operation without neurologic deficit.

Parascapular free flap for facial augmentation in progressive facial hemiatrophy.

Three cases of progressive hemiatrophy which werre treated by de-epithelialized parascapular free flaps are reported. This flap is accesble, easy to dissect and has constant anatomy of the nutrient vessels. The bulkiness of the flap is adequate for severe deformities.

Free Vasularized Scapular and Parascapular Flap / 대한정형외과학회잡지

The trestment of extensive soft tissue injury of the extremities is known to be one difficulty in the field of Orthopedic Surgery. The authors present a study of 55 free vascularized scapular flaps, 12 free vascularized parascapular flaps and 9 combined scapular and latissimus dorsi flaps for extensive soft tissue injury of the extremities at the Department of Orthopedic Surgery, Severance Hospital from March 1983 to December 1988. The results of the study are as follows:1. The pedicles of the flap were consistent in length and diameter. 2. The flap was uniform and relatively thin in thickness in free scapular and psrascapular flaps 3. There was no limitation to motion of the shoulder despite excision of the scapular and parascapular flap. 4. Primary closure of the donor flap was feasible in almost all cases. 5. Reconstruction of a 1arge soft tissue defect was possible with scapular and parascapular flap in one stage. 6. The free vaseularized scapular flap and parascapular flap would be recommended of one-stage reconstructional surgery for extensive soft tissue defects.