3 years ago

Supraclavicular Flap as a Salvage Procedure in Reconstruction of Head and Neck Complex Defects

Helio R.n. Alves, Jose Carlos Marques De Faria, Rafael Varella Dos Santos, Claudio Cernea, Fabio Busnardo, Rolf Gemperli

Publication date: Available online 8 January 2019

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): Helio R.N. Alves, Jose Carlos Marques de Faria, Rafael Varella dos Santos, Claudio Cernea, Fabio Busnardo, Rolf Gemperli

Abstract

The supraclavicular island flap (SCIF) is an interesting therapeutic option in head and neck reconstruction. Since popularized by Pallua in the late 90’s, several clinical series have been published showing its versatility and usefulness. However, only a few studies have focused on factors associated with complications from SCIF use. In this study, we analyzed the factors contributing to SCIF unreliability. We performed a retrospective review of the data of 87 patients undergoing SCIF reconstruction between 2008 and 2015. No significant differences in mean complication rates were observed when the SCIF was used for primary or salvage reconstruction (28% versus 25%, respectively, p= 0.816) or for cutaneous or intraoral reconstruction (27% versus 28%, respectively, p=0.932). Flap folding, preoperative radiotherapy, and microsurgery were associated with significantly increased complication rates (p=0.002, p=0.043, and p=0.001, respectively), whereas smoking (p=0.431) had no impact in this regard. In conclusion, the SCIF is a versatile flap and an important therapeutic tool for use in salvage surgeries, particularly in those performed in patients with poor clinical conditions and limited flap options.

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