The Supraclavicular Flap in Head and Neck Reconstruction

Abstract

The supraclavicular artery island flap has recently become increasingly used for the reconstruction of complex soft-tissue defects after head and neck oncologic ablative procedures. In an aging population with multiple comorbidities, with surgery often being performed in the salvage setting, many patients who are not good candidates for free tissue transfer are in still need of advanced reconstructive options. The goal of this article is to review the evolution of this flap and to highlight the recent technical modifications and outcomes data regarding the use of the supraclavicular flap in head and neck reconstruction. The supraclavicular artery island flap provides a versatile fasciocutaneous flap with minimal donor site morbidity that affords the reconstructive surgeon a thinness, pliability, color, and texture unmatched by other regional pedicled flaps. It is cost-effective and has been shown to have similar functional outcomes to free tissue transfer for a variety of ablative defects, including those of the lateral skull base and parotid, larynx, oral cavity, and oropharynx. The supraclavicular artery island flap has a number of proven advantages in the reconstruction of complex soft-tissue defects after head and neck oncologic ablative procedures. In an era in which salvage surgery is increasingly being performed in an aging patient population with rising comorbidities, the supraclavicular artery island flap provides a reliable, efficient alternative to free tissue transfer reconstruction that can ultimately result in decreased healthcare costs and lower patient morbidity.