Superficial Circumflex Iliac Artery Perforator Flap as a Workhorse Flap: Systematic Review and Meta-analysis

Abstract

There are various advantages and disadvantages attributed to superficial circumflex iliac artery perforator (SCIP) flap. The aim of this study is to evaluate the versatility and reliability of free SCIP flap by performing a systematic review and meta-analysis of the literature in terms of flap characteristics, pedicle types, and outcomes, including the different types of flap elevations. PubMed, Embase OVID, and Cochrane CENTRAL were searched up to January 2019. All original articles and case reports published in English were included in the analysis. Anatomic descriptions, cadaveric studies, conference presentations, letter to the editors, local SCIP flaps, and review articles were excluded. A total of 36 articles including 907 SCIP flaps were available for the analysis. The most frequent causes of defects were tumors (38.2%) and lower extremities were the most common recipient areas (62.7%). The average flap dimension was 73.3 ± 23.0 cm2 with a pedicle length of 5.0 ± 0.6 cm. Vessel diameter average was 0.67 ± 0.12 mm. The average number of deep branch and superficial branch used per study was 14.4 ± 8.7 (18%) and 93.3 ± 75.0 (84%), respectively. Flap failure rate and complication rate were 2.7 and 4.2%, respectively. SCIP flaps have been shown to be versatile in various aspects of reconstruction. The attributed disadvantages such as having short pedicle and small vessel diameter do not seem to limit the variable usage of this flap. Therefore, SCIP flap should be considered a workhorse flap.