OBJECTIVETo investigate the feasibility and therapeutic effect of lateral thoracic flaps pedicled with subscapular vessels for defects in the upper extremities.

METHODSFrom June 2003 to September 2009, 5 cases with large soft tissue defects in the upper extremities were treated with lateral thoracic flaps pedicled with subscapular vessels. The flap size ranged from 23 cm x 8 cm to 40 cm x 20 cm. The subscapular vessels, the thoracodorsal vessels, the lateral branch and the cutaneous perforators of thoracodorsal vessels were all included in the flap. A muscular sleeve of 2-3 cm in width was preserved to protect the musculocutaneous perforator. The defects in the donor area were closed directly or covered by skin graft.

RESULTSThe lateral thoracic flaps were used in four cases. A combination of lateral thoracic flap and paraumbilical flap was used in one case. Partial necrosis happened at the distal portion of the flap in one case. All the other flaps survived completely. 4 cases were followed up for two to fourteen months with satisfactory cosmetic and functional results. The color, texture and thickness of the flaps were also satisfactory.

CONCLUSIONSThe lateral thoracic flap pedicled with the subscapular vessel is flexible for repairing defects in the upper extremities with a reliable blood supply, leaving less morbidity to donor site.