Supraclavicular artery island flap for head and neck reconstruction

Abstract

The ablative surgical resection has acritical importance for achieving better oncological outcomes for patients with head and neck cancer. However, radical surgical resections reveal the reconstruction requirement of complex anatomical structures. Microvascular free flaps have been recommended as agold standard treatment choice for head and neck reconstruction following definitive oncological surgery. The supraclavicular artery island flap (SCAIF) is athin and reliable fasciocutaneous pedicled flap that is simple and quick to harvest. Atotal of 19 patients who underwent head and neck reconstruction with SCAIF were included in this study. The SCAIF was used for the reconstruction of oncological defects in 17 patients while it was used for the reconstruction of askin defect on the lower face following radiotherapy in 1 patient and for cervical open wound (blast injury) closure in 1 patient. There were neither intraoperative nor postoperative major complications in any patient. The SCAIF has been used successfully in 18 of 19 patients for head and neck reconstructive surgery. Partial necrosis of the skin was detected in 1 patient (5.3%) only, while atotal flap failure has not occurred in any patient. The partial skin necrosis was seen in an area of 1.5 cm of the distal end of the flap and was managed conservatively with local wound care. Wound dehiscence has not appeared in the flap donor area in any patient. The SCAIF constitutes agood alternative to free flaps, providing almost equivalent functional results and requiring less operative time and surgical effort.