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  • Title: Serratus anterior free flap in oral reconstruction.
    Author: Tavassol F, Rücker M, Barth EL, Kokemüller H, Bormann KH, von See C, Gellrich NC.
    Journal: J Oral Maxillofac Surg; 2009 Dec; 67(12):2577-82. PubMed ID: 19925974.
    Abstract:
    PURPOSE: Perforating oral and maxillofacial defects frequently cause severe functional disorders. Microvascular free flaps like the radial forearm flap and the latissimus dorsi flap have been described to cover those defects; however, harvest of the radial forearm flap causes remarkable donor-site morbidity, while the latissimus dorsi flap often turns out to be too bulky. Therefore we introduce the serratus anterior muscle as a versatile and reliable microvascular flap to cover defects of both the floor of the mouth and the maxilla. PATIENTS AND METHODS: Between 2003 and 2007, 10 oral defects were reconstructed using the serratus anterior flap. In 5 of the cases, the defects were located at the hard palate and maxilla, while in the other cases they were located in the floor of the mouth. RESULTS: All of the patients were able to feed orally within the first week postoperatively. Donor-site morbidity was observed to be negligible not least because of the achievement of primary tension-free wound closure. Successful reconstruction could be observed in 8 of 10 patients. CONCLUSION: Although the serratus anterior muscle flap lacks an epithelial layer, this flap is not restricted to a subcutaneous placement. Due to rapid epithelialization, the serratus anterior muscle is even suitable for perforating intraoral defects.
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