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Open Access
CC BY 4.0 · Arch Plast Surg
DOI: 10.1055/a-2778-4044
Case Report

Novel Use of Chimeric Serratus Anterior Fascia–Latissimus Dorsi Flap for Composite Cranial Defect: Case Description and Review of the Literature

Authors

  • James Antongiovanni 

    1   Plastic Surgery, University of California Irvine, Orange, United States (Ringgold ID: RIN8788)
    2   Medical Education, Washington State University Elson S Floyd College of Medicine, Spokane, United States (Ringgold ID: RIN445950)

  • Nikhil Shah

    1   Plastic Surgery, University of California Irvine, Orange, United States (Ringgold ID: RIN8788)

  • Chizoba Ama Mosierei

    1   Plastic Surgery, University of California Irvine, Orange, United States (Ringgold ID: RIN8788)
    3   Medical Education, LSU Health Shreveport School of Medicine, Shreveport, United States (Ringgold ID: RIN12257)

  • Sarah Struble

    1   Plastic Surgery, University of California Irvine, Orange, United States (Ringgold ID: RIN8788)

  • Hoyune E. Cho

    1   Plastic Surgery, University of California Irvine, Orange, United States (Ringgold ID: RIN8788)

  • Medha Vallurupalli

    4   School of Medicine, USC Keck School of Medicine, Los Angeles, United States (Ringgold ID: RIN12223)

  • Gabrielle Labove

    1   Plastic Surgery, University of California Irvine, Orange, United States (Ringgold ID: RIN8788)

  • Miles J Pfaff

    5   Plastic Surgery, UC Irvine Healthcare, Orange, United States (Ringgold ID: RIN14447)
Further Information
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Background: Effective soft tissue coverage is essential for minimizing complications in large cranial defects. This case report describes the successful application of a chimeric serratus anterior fascia-latissimus dorsi (SAFLD) flap for single-stage coverage of a large cranial defect. This technique is compared to the current literature. Methods: A 69-year-old female with a history of glioblastoma and a rapidly growing scalp squamous cell carcinoma underwent en-bloc resection and single-stage reconstruction. After cranioplasty, a large defect was covered with a SAFLD flap, ensuring multilayered vascularized soft tissue coverage. Results: Recovery was uneventful, and a one-year follow-up demonstrated good cranial morphology. Conclusion: This case demonstrates the successful application of a chimeric free flap for dual-layer coverage in cranial reconstruction, potentially reducing complications associated with single-stage repairs and improving patient outcomes. A literature review demonstrating various case applications of this flap is also presented.



Publication History

Received: 21 March 2025

Accepted after revision: 22 December 2025

Accepted Manuscript online:
05 January 2026

© . The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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