The reevaluation and surgical strategy of the superficial circumflex iliac artery perforator (SCIP) flap

Abstract

Objective To introduce the classification of the perforators of the superficial circumflex iliac artery (SCIA) , and the superficial circumflex iliac artery perforator (SCIP) flaps based on different perforators have different characters and harvesting methods. To explore a set of coping strategy for the drawbacks of the SCIP flap. Methods Review 90 cases of SCIP flaps in August, 2011 to June, 2017. The pre-operative radiology navigation was conducted in all cases. Different surgical approaches were applied in flaps based on different perforators. The pedicle elongation method was adopted when necessary. The thickness of the flap, the length of the pedicle, the survival rate of the flap and the closure of the donor site were analyzed. Regular follow-up was performed after the operation. Results All flaps were followed-up for 6-15 months (average 8 months) . Fifty-seven flaps were raised on the basis of the proximal perforators of the superficial branch of the SCIA, whereas 29 cases were based on the distal perforators from the deep branch, and in 4 cases, the pedicle was switched to the superficial inferior epigastric artery. In 8 cases, the arterial pedicle lengthen technique was applied with a maximum length of 10 cm. All donor sites were closed directly. Conclusion These surgical strategies simplified the intraoperative decision-making and conquered the shortcomings of the SCIP flap. It is believed that the SCIP flap can possibly become the new workhorse flap in the field of reconstructive surgery. Key words: Superficial circumflex iliac artery perforator flap; Computed tomographic angiography(CTA); Color Doppler sonography ultrasound(CDU); Preoperative radiology navigation