A freestyle pedicled thoracodorsal artery perforator flap aiding the donor-site closure of a parascapular flap.

We present a patient with a neck burn scar contracture. A parascapular free flap is used to re-surface the cervical defect, while the resultant donor-site defect is reconstructed by a freestyle pedicled thoracodorsal artery perforator flap. With the introduction of a freestyle pedicled perforator flap, large-sized donor-site defects of the parascapular flap can be closed easily and safely with minimal donor-site morbidity. The parascapular flap is the workhorse flap for defect reconstruction in our centre. The advantages of this flap have been well documented in the literature. One of the main drawbacks of the parascapular flap is that the donor site is difficult to close primarily if the flap width is significantly wide. Although Nassif reported that it can be closed directly even if the flap width is up to 15 cm, in our experience, it is possible and easy to close the donor site directly when the flap width is under 12 cm. Alternatively, split-thickness skin grafting is needed to prevent the wound dehiscence. In this article, we describe a technique in which the donor site of the parascapular flap was reconstructed by a freestyle pedicled thoracodorsal artery perforator flap, thereby reducing the donor-site morbidity to the minimum.