Supraclavicular artery flaps for head and neck reconstruction: a prospective study
DOI:
https://doi.org/10.18203/2349-2902.isj20203794Keywords:
Fascio-cutaneous, Head and neck defects, Reconstruction, Supraclavicular arteryAbstract
Reconstruction of defects of the head and neck remains a challenge to the reconstructive surgeon. This is due to the complex anatomy of the region as well as the age and comorbidities of the patients, which prevent the use of free tissue transfer as the primary tool of reconstruction. The supraclavicular artery (SCA) island flap is a well vascularised tissue and provides a thin and pliable skin for cutaneous and mucosal defects of the head and neck region. Here, we had done this flap for eight patients with no major complications and hence, we concur that it is a safe, reliable and versatile reconstructive option for these defects. The study period was from January 2015 to June 2016 where we operated on 8 patients, 5 for post burn contracture neck and 3 for post oncologic resection. The flap was used as a pedicled fascio-cutaneous and was based on the transverse supraclavicular artery. Eight cases underwent supraclavicular artery flap of which 5 were males and 3 females. Mean defect size was 15×10 cm. All the donor sites were closed with a split skin graft. One patient had distal necrosis which was managed with debridement and secondary suturing. The supraclavicular artery flap is a thin, versatile, reliable and easy to harvest flap for reconstructing head and neck defects, with good cosmetic and functional outcome.
References
Cha YH, Nam W, Cha IH, Kim HJ. Revisiting radial forearm free flap for successful venous drainage. Maxillofac Plast Reconstr Surg. 2017;39:14.
Su T, Pirgousis P, Fernandes R. Versatility of supraclavicular artery island flap in head and neck reconstruction of vessel-depleted and difficult necks. J Oral Maxillofac Surg. 2013;71:622-7.
Kokot N, Mazhar K, Reder LS, Peng GL, Sinha UK. The supraclavicular artery island flap in head and neck reconstruction: applications and limitations. JAMA Otolaryngol Head Neck Surg. 2013;139:1247-55.
Pallua N, Noah ME. The tunnelled supraclavicular island flap: an optimized technique for head and neck reconstruction. Plast Reconstr Surg. 2000;105:842-51.
Nthumba PM. The supraclavicular artery flap: a versatile flap for neck and orofacial reconstruction. J Oral Maxillofac Surg. 2012;70:1997-2004.
Christian W, Martin C, Sabina SZ, Jennifer SL, Bernhard WG, Yiannis P. Oral Cancer Reconstruction Using the Supraclavicular Artery Island Flap: Comparison to Free Radial Forearm Flap. J Oral Maxillofacial Surg. 2017;75(10):2261-9.
Gillies HD. The tubed pedicle in plastic surgery. J Laryngol Otology. 1923;38:503-3.
Kazanjian VH, Converse J. The Surgical Treatment of Facial Injuries, Williams and Wilkins, Baltimore, Md, USA; 1949.
Mathes SJ, Vasconez LO. The cervico-humeral flap. Plastic Reconstructive Surg. 1978;61:7.
Lamberty BGH, Cormack GC. Misconceptions regarding the cervico-humeral flap. British J Plastic Surg. 1983;36(1):60-3.
Pallua N, Machens H, Rennekampff O, Becker M, Berger A. The fascio-cutaneous supraclavicular artery island flap for releasing postburn mentosternal contractures. Plastic Reconstructive Surg. 1997;99(7):1878-84.
Pallua N, Demir E. Postburn head and neck reconstruction in children with the fascio-cutaneous supraclavicular artery island flap. Annals Plastic Surg. 2008;60(3):276-82.
Chiu ES, Liu PH, Friedlander PL. Supra-clavicular artery island flap for head and neck oncologic reconstruction: indications, complications, and outcomes. Plastic Reconstructive Surg. 2009;124(1):115-23.
Ross RJ, Baillieu CE, Shayan R, Leung M, Ashton MW. The anatomical basis for improving the reliability of the supraclavicular flap. J Plast Reconstr Aesthet Surg. 2014;67:198-204.
Vinh VQ, Anh VT, Ogawa R, Hyakusoku H. Anatomical and clinical studies of the supraclavicular flap: analysis of 103 flaps used to reconstruct neck scar contractures. Plast Reconstr Surg. 2009;123:1471-80.
Tayfur V, Magden O, Edizer M, Menderes A. Supraclavicular artery flap. J Craniofac Surg. 2010;21:1938-40.
Herr MW, Bonanno A, Montalbano LA, Deschler DG, Emerick KS. Shoulder function following reconstruction with the supraclavicular artery island flap. Laryngoscope. 2014;124:2478-83.
