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Seven free scapular fascial flaps with a skin graft on top were used to cover soft tissue defects of the hand and foot in 6 patients during the past two years. The size of the flap ranged from 7 x 8 cm to 8 x 12 cm. All flaps survived well, but one had partial loss as a result of infection. The advantages, disadvantages, indications, and important technical points of the surgery are discussed.

Postburn breast deformity is a sequelae of severe scar contraction of the burned chest. During the past four years, 6 female patients with such a deformity required reconstruction, and the surgery was performed in our department. Three different types of breast reconstruction were undertaken, each one achieving a satisfactory aesthetic result.

Four cases with defects at varying sites were reconstructed with the medial genicular flap. Three cases utilized free microvascular skin flaps based on the saphenous artery and one case a pedicled flap based on the same artery. All flaps survived well with satisfactory functional and cosmetic results. Regional anatomy is briefly reviewed, dissection of the flap is described in detail, and some special technical points are mentioned.

The free scapular fascial flap based on the circumflex scapular vessels with skin graft on top has been used to cover the soft-tissue defects in 6 cases--5 hands and 1 foot, over the past one year. The size of the fascial flap ranged from 10 x 6 to 13 x 7 cm. Five flaps were survival completely and one with loss of a small portion due to infection. Compared with the cutaneous flap, myocutaneous flap or muscular flap, the fascial flap is thinner, showing no bulkiness on the recipient site, and also no impairment was noted in the donor site. The shortcoming is darker colour of the skin graft overlying it. The authors consider that the free fascial flap is mainly indicated for the soft-tissue defects of the extremities and those sites where no augmentation is required.

We present a technique using a reversed island forearm fascial flap based on the distal portion of the radial artery and veins, with a skin graft on top, to repair a soft tissue defect of the hand. Good results were obtained in a total of 18 operations in 17 postburn cases. The operation can be completed in one stage even when it involves the excision of scar tissue, correction of the secondary deformities of deep structures, and repair of the soft tissue defect of the hand. The advantages and disadvantages of the method and key points of the technique are discussed.