Aim: The aim of this study is to elaborate the concept of delayed inset of free parascapular flap over certain 
soft tissue defects in head and neck and lower limbs. The final inset is usually done 5-7 days following the 
main microsurgical operation after being sure of flap survival.
Methods: Twelve patients (9 males, 3 females), patient age range 12 to 58 years were treated with free 
fasciocutaneous parascapular flaps from the period from January 2007 to January 2010. The soft tissue 
defects were 4 in the head and neck region and 8 cases in middle and distal third of the leg.
Results and Conclusion: In all the twelve flaps the concept of delayed inset of the flap was applied, and 
final inset was achieved after 5-7 days after the first microsurgical operation. 
The time of the first operation was reduced (average time was 3-5 hours). The second operation time was 
between 70 minutes -100 minutes.
The delayed inset of the parascapular flap prevents exposure of important structures that could occur if 
debridement around the recipient defect is done and then partial or total flap loss occurs, it also avoids the 
blood loss that results from excision and preparation of the area around the recipient defect. This blood loss 
if added to the blood loss of the flap dissection and microsurgical anastomosis may affect the healing power 
of the flap.