Supine positioning for the subscapular system of flaps: A pictorial essay

Background: This pictorial essay demonstrates a modification to the positioning, prepping, and draping technique for the subscapular system of flaps allowing the patient to be placed supine and without the need for a second assistant during the harvest or closure. Methods and Results: We performed a literature review focusing on the positioning of the patient during the harvest of the subscapular system of flaps. A supine modification harvest prepping, draping, and position is then described in pictorial essay format. The technique is made possible with the use of a Mayo stand to position the arm. Discussion: A literature review demonstrates limited description of nonlateral decubitus position harvest of the scapular flap. A novel positioning technique is described in pictorial essay format to demonstrate the ease and feasibility without the need for a second assistant during the case, an important goal in the era of limited resident duty hours.