Resurfacing large skin defects of the face and neck with expanded subclavicular flaps pedicled by the thoracic branch of the supraclavicular artery

Abstract

BackgroundSupraclavicular flaps had been widely used as pedicled flaps to reconstruct face and neck defects. However, the size of this traditional flap was limited even after expansion. In this study, we present a flap pedicled by the thoracic branch of supraclavicular artery (TBSA). The flap is located at the subclavicular region, and has the advantage of large dimension, matching colour and thin thickness. MethodsIn this series, 24 patients with ages ranging between 3 and 49 years (30 flaps with six patients in bilateral fashion) were treated in the authors’ institution. ResultsThe maximum size of the flap was 25cm×25cm, whereas the minimum size was 15cm×10cm. The average size of the flaps was 241.1±95.7cm2. Twenty-six flaps (86.7%) survived completely. Total flap loss was seen in one patient (3.3%) and was treated with reverse harvesting skin graft. Partial flap necrosis occurred in three flaps (10.0%). Through a mean time of 10-month follow-up, the colour and the texture of the flaps matched with the recipient area. No conspicuous flap contracture was observed. ConclusionThis expanded subclavicular flap pedicled by the TBSA has proved to be a promising method with satisfactory outcome and high success rate.