Combined scapular osteocutaneous and latissimus dorsi myocutaneous flap for composite mandibular reconstruction

Twelve patient underwent composite mandibular and soft tissue reconstruction following resection of T4 oral cancer and/or osteo-radio necrosis of mandible. The length of the scapula used for mandibular reconstruction was between 5cm and 16cm. The free tissue transfers were successful in eleven patients. One patients had total flap loss due to a severe wound infection by MRSA. The other flaps survived without any partial necrosis. The combination of the scapular osteocutaneous flap with latissimus dorsi myocutaneous flap allows reliable reconstruction of massive and three-dimensional composite mandibular defects.