Practical tips for harvesting scapula osteocutaneous flap

Scapular flaps have a versatile nature that allows numerous combinations of skin, muscle, and bone. Additionally, atherosclerosis rarely affects the pedicle, which offers further advantages in patients with peripheral artery disease. Given the anatomical location, scapular flaps favor early patient ambulation and are not associated with long-term movement limitations in the lower extremity. Both scapular and parascapular osteocutaneous flaps are associated with acceptable postoperative morbidities, allowing for primary closure without skin graft and a well-hidden scar. Nonetheless, several key points or pitfalls must be carefully addressed to avoid surgical complications and undesired outcomes. One of the main limitations of harvesting the scapula flap is positioning. A two-team approach is usually difficult, and additional time is required for patient positioning. The purpose of this chapter is to review pearls and pitfalls for harvesting scapula osteocutaneous flap.