SCIV-only versus VCs-only conduit: Which is optimal for multipaddle and chimeric SCIAP flaps?

Abstract

BackgroundSuperficial circumflex iliac vein and venae comitantes was qualified for traditional superficial circumflex iliac artery perforator flaps. Optimal approaches for multipaddle and chimeric SCIAP flaps remains elusive. The purpose of this study is to investigate validities of SCIV-only and VCs-only conduit for such extended SCIAP flaps. MethodsA retrospective study was conducted from August 2015 to July 2023 at the author's institution. All patients who underwent multipaddle and chimeric SCIAP flaps with complete follow-up information were involved. The multipaddle SCIAP flaps included 2, 3, and 4-paddle variations, while the chimeric series involved cutaneous-iliac and cutaneous-sartorius SCIAP flaps. A comparison was made between the primary outcomes of the SCIV-only group and VCs-only group in terms of the proportion of these variations and complications, as well as operation duration, and wound healing time. ResultsOf 195 patients,VCs-only conduit accounts for 85.6% (n=167), and 14.4% (n=28) for SCIV-only approach. In SCIV-only group, 89.3% were performed for 2-paddle flaps. In VCs-only group, 167 flaps were drained by this approach, including 43 (25.8%) cases of 2-paddle, 38 (22.8%) cases of 3-paddle, 22 (13.2%) cases of 4-paddle, 36 (21.6%) cases of cutaneous-iliac, and 28 (16.8%) cases of cutaneous-sartorius flaps. The utilization rate of the VCs-only conduit was 63.2% in 2-paddle, 92.7% in 3-paddle, and 100% in 4-paddle and chimeric SCIAP flaps. ConclusionThis study stands in support of VCs-only drainage for multipaddle and chimeric SCIAP flaps due to its effective drainage capacity of suprafascial and subfascial tissues.