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Supraclavicular Artery Island Flap: Have We Found an Ideal Regional Flap for Head & Neck Oncologic Reconstruction?
Ernest S. Chiu, MD1, Paul L. Friedlander, M.D.2.
1NYU Langone Medical Center, New York, NY, USA, 2Head & Neck Oncology, Tulane School of Medicine, New Orleans, LA, USA.
PURPOSE: The supraclavicular island flap has been successfully used various challenging facial reconstruction cases providing acceptable results without using microsurgical techniques. The authors use this regional flap in reconstructing various head and neck oncologic defects which normally require traditional regional or free flaps to repair surgical wounds.
METHODS: A pedicled supraclavicular artery flap (SCAIF) was used to reconstruct head/neck oncologic defects. Retrospective study using a prospectively maintained database was performed to evaluate complications, functional and aesthetic outcomes.
RESULTS: Head and neck oncologic patients underwent tumor resection followed by immediate reconstruction for various defects using a SCAIF. Ablative defects include neck, tracheal-stomal, cheek, mandible, parotid, pharyngeal, intraoral, and lateral skull base. All (n=128) flaps were harvested in under one hour by senior surgeon. Ablative wounds and donor sites were closed primarily. Additional surgical revision was infrequent. Major complications included partial/complete flap loss requiring 2nd regional flap and blood transfusion. None of the cases required free tissue transfer. There were no deaths related to this surgery. Minor complications included donor site wound dehiscence and cellulitis. None of the patients reported functional donor site morbidity.
CONCLUSION: We present the largest clinical case series for the use of SCAIF in head/neck oncologic reconstruction. This thin, versatile, fasciocutaneous flap is easy and quick to harvest, has a reliable pedicle, and minimal donor site morbidity. Since our initial report, it has become our preferred workhorse regional flap choice for common head and neck oncologic reconstructive problems. The supraclavicular artery island flap is a reasonable flap option for patients not requiring free tissue transfer procedure.
REFERENCE:
1. Chiu ES, Liu PH, Friedlander PL.Supraclavicular artery island flap for head and neck oncologic reconstruction: indications, complications, and outcomes. Plast Reconstr Surg. 2009 Jul;124(1):115-23.
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