Abstract
Introduction: Radial forearm free flap (RFFF) and supraclavicular artery island flap (SCAIF) are some of the most common fasciocutaneous flaps used for head and neck (H&N) reconstruction.Material and methods: A retrospective analysis of clinical data and outcomes of 31 consecutive patients who underwent H&N reconstruction using either SCAIF or RFFF over a three-year period, aiming to compare the surgical outcomes of the SCAIF and the RFFF in H&N reconstruction.Results: Thirty-two flaps were performed in 31 patients (17 SCAIFs and 15 RFFFs). There was no difference in patient demographics between both groups. Hospital stay was longer in the SCAIF group (30.7 ± 18.2 days (min: 9/max: 60) versus 19.2 ± 15.8 days (min: 7/max: 72). Patients who underwent reconstruction with a SCAIF had shorter reconstructive procedure time; 74.4 min (min: 60/max: 93) versus 147.8 min (min: 140/max: 187). Overall morbidity was not significantly different (SCAIF 52.7% vs RFFF 39.9%, p = NS). Global flap survival was higher without statistical significance in the RFFF group (100%) versus the SCAIF group (70.7%).Conclusion: Despite the advantages related to the use of SCAIF like regarding the time spent in the reconstructive procedure. In our experience, the RFFF continues to be the most successful technique with similar perioperative outcomes and fewer complication rates. In this vein, both techniques can be reasonably used to reconstruct post-ablative H&N defects. However, in our experience, the use of SCAIF may lengthen hospital length of stay probably due to the augmented risk of flap failure.
Highlights
Radial forearm free flap (RFFF) and supraclavicular artery island flap (SCAIF) are some of the most common fasciocutaneous flaps used for head and neck (H&N) reconstruction
Some patients may not be suitable for free tissue transfer (FTT) because of older age, poor nutritional status, medical comorbidities, vascular problems often associated with high tobacco or alcohol consumption, the higher risk of prolonged surgeries [6], or the lack of recipient’s vessels because of previous treatments, especially in patients with metachronous or recurrent tumors [7]
We found a significant difference between both groups according to the mean length of hospital stay; the RFFF group was discharged in 19 ± 16 days while the SCAIF group was discharged in 31 ±
Summary
Radial forearm free flap (RFFF) and supraclavicular artery island flap (SCAIF) are some of the most common fasciocutaneous flaps used for head and neck (H&N) reconstruction. Head and neck (H&N) reconstructive surgery aims to solve those problems occurring post tumor ablative resection from an anatomical region with multiple implications over the patient’s quality of life. The aesthetic defects related to the surgery can be sometimes unacceptable In this vein, the ideal flap for H&N reconstruction procedures should appropriately restore both form and function of the defect and in just one surgical act. Some patients may not be suitable for free tissue transfer (FTT) because of older age, poor nutritional status, medical comorbidities, vascular problems often associated with high tobacco or alcohol consumption, the higher risk of prolonged surgeries [6], or the lack of recipient’s vessels because of previous treatments, especially in patients with metachronous or recurrent tumors [7]. FTT requires considerable technical expertise, a longer learning curve, special instrumentation, specialized post-operative monitoring and care, and prolonged hospital stay
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