To assess the clinical effects of repair of large area soft tissue defect on the dorsal side of the foot by serratus anterior myofascial flap transplantation.

Between January 2015 and January 2019, 16 patients with large area soft tissue defect on the dorsal side of the foot were treated by serratus anterior myofascial flap transplantation. There were 11 males and 5 females, aged from 24 to 50 years, mean of (36.6±5.3) years. The size of the soft tissue defect ranged from 13 cm×8 cm to 9 cm×6 cm. A serratus anterior myofascial flap was harvested with subscapular and circumflex scapular arteries forming a T-shaped vascular pedicle. The T-shaped vascular pedicle of the serratus anterior myofascial flap was anastomosed to the two ends of the anterior tibial artery at the recipient site by end-to-end anastomosis. Coverage of the myofascial flap was performed with a meshed split-thickness skin graft.

All myofascial flaps survived completely. The patients were followed up for 1.2-4.5 years, with average of (3.4±2.3) years. A good contour was confirmed at the recipient and donor sites. The outcomes were excellent in nine patients, good in six, and fair in one, with an excellent or good rate of 3.75%. Satisfactory clinical results were achieved in this series.

This technique is safe, reliable, and particularly suitable for repairing large area soft tissue defect on the dorsal side of the foot and reducing the damage to main vessels of the recipient site.