OBJECTIVETo investigate the application of free anterior serratus musculo-fascial flap in bridge style for the soft tissue defect at leg.

METHODSFrom Sept. 2006 to Jan. 2009, the free anterior serratus musculo-fascial flaps were used in bridge style in 7 cases with soft tissue defects at legs. The anterior serratus musculo-fascial flaps were elevated with subscapular and circumflex scapular vessels forming a T-shaped vascular pedicles. The T-shaped pedicle was end-to-end anastomosed with the two ends of the posterior tibial artery at the healthy leg. The musculo-fascial flap and its pedicle were covered with skin graft.

RESULTSAll the 7 flaps survived completely with satisfactory result. The patients were followed up for 9-42 months with good functional and esthetic result both in donor site and recipient site. The patency of posterior tibial artery was demonstrated by clinical and Doppler examination.

CONCLUSIONSThis technique is particularly useful in leg reconstructive surgery when only one vessel remains. The patency of the posterior tibial artery at the healthy leg is preserved and the morbidity in donor site is minimal.