Unusual pattern of partial failure of preexpanded free parascapular flap for neck reconstruction

The present article focuses on a relatively rare condition of a partial necrosis of free microvascular flap in a patient with severe postburn contracture of the neck region, subjected to reconstructive microsurgery. Reconstructive microsurgical staged procedure was undertaken to correct the scar contracture and restore the aesthetic unit. Substantial partial flap necrosis, requiring secondary surgery, was observed in the early postoperative period. Surprisingly only the distal 1/3 of the skin island of the parascapular flap survived. Final reconstruction of the neck reconstruction was accomplished by means of full thickness skin graft over the area of partially necrotic flap. Good final result was achieved. Overall treatment course is discussed in the light of the current trends.