Novel Use of Chimeric Serratus Anterior Fascia-Latissimus Dorsi Flap for Composite Cranial Defect.

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. 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 an SAFLD flap, ensuring multilayered vascularized soft tissue coverage. Recovery was uneventful, and a 1-year follow-up demonstrated good cranial morphology. 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.