Supine positioning for the subscapular system of flaps: A pictorial essay

Head Neck. 2018 May;40(5):1068-1072. doi: 10.1002/hed.25051. Epub 2018 Feb 27.

Abstract

Background: This pictorial essay demonstrates a modification to the positioning, prepping, and draping technique for the subscapular system of flaps allowing the patient to be placed supine and without the need for a second assistant during the harvest or closure.

Methods and results: We performed a literature review focusing on the positioning of the patient during the harvest of the subscapular system of flaps. A supine modification harvest prepping, draping, and position is then described in pictorial essay format. The technique is made possible with the use of a Mayo stand to position the arm.

Discussion: A literature review demonstrates limited description of nonlateral decubitus position harvest of the scapular flap. A novel positioning technique is described in pictorial essay format to demonstrate the ease and feasibility without the need for a second assistant during the case, an important goal in the era of limited resident duty hours.

Keywords: free flaps; head and neck surgery; reconstructive surgery; scapula; subscapular.

Publication types

  • Review

MeSH terms

  • Free Tissue Flaps*
  • Humans
  • Patient Positioning*
  • Plastic Surgery Procedures*
  • Scapula
  • Supine Position*