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For years, various types of fascial flaps have been used in clinical practice; however, there are many unanswered questions regarding their basic physiology, anatomy and histopathologic changes occurring after transfer. Simple and reliable flap models are needed to investigate these questions, but very few of these flap models have been described in experimental animals to date. The purpose of this study was to describe a new reliable fascia flap model in the dog-the dorsal thoracic fascia flap. This fascia is defined as the anatomic layer that contains the blood supply to the scapular and parascapular fasciocutaneous flaps. Fourteen adult dogs were used in this experiment. The vascular anatomy of the dorsal thoracic fascia was studied by anatomic dissection and microangiography. Anatomic dissection revealed that the main axial vessel supplying the dorsal thoracic fascia was the superficial branch of the thoracodorsal vessel. Based on the vascular pedicle, fascia flaps generally measuring 15 x 24 cm were created. At gross observation, all of these large flaps based solely on the vascular pedicle were observed to be well-perfused. Microangiographic examination revealed the intense vascularity of the superficial branches of the thoracodorsal vessels in the whole area of all flaps. It was concluded that this is a simple and reliable fascial flap model which can be prepared as a free or pedicled flap. It has a consistent, long vascular pedicle with large vessel diameters supporting a large fascial flap.

Reconstruction with the latissimus dorsi muscle flap, combined with the serratus anterior fascia flap, was performed to cover two large and separate palmar and dorsal forearm skin defects in a patient, whose hand had been replanted 20 days earlier after traumatic amputation at the distal forearm level. As a result, a total forearm amputation was salvaged by microsurgical replantation and a free combined flap of the subscapular system. This new application of the combined flap allowed the reconstruction of large and separate wounds of the replanted hand, and provided gliding surfaces for tendons.