Surgical anatomy of the serratus anterior-rib composite flap.

Dissection of 40 cadavers demonstrates that the serratus muscle has a constant anatomy. If it is used as a muscle flap, it is reliable with a consistently long pedicle, excellent malleability and multipennate anatomy permitting coverage of complex three dimensional wounds of the face and limbs. The anastomosis, around the rib, between its vessels and those arising from the intercostal artery are useful if it is raised as a rib-composite flap.