Safe and reliable use of supraclavicular flaps for head and neck reconstruction.

J Craniofac Surg

Department of Plastic and Reconstructive Surgery, Kyushu University Hospital, Fukuoka, Japan.

Published: July 2024

AI Article Synopsis

  • * A study from 2014 to 2023 involved four cases using this flap for cervical and pharyngeal defects, with careful design to minimize complications by keeping the flap within specific anatomical limits.
  • * Successful reconstructions were achieved without flap-related issues, and donor scars were discreet, highlighting the importance of careful flap design and methods like tension-free insets for effective results.

Article Abstract

The supraclavicular flap is a regional flap in the supraclavicular area nourished by the transverse cervical or supraclavicular arteries. This flap gained popularity in the 2000s as it requires less surgical time than free flap reconstruction and has minimal donor-site morbidity. However, a high rate of postoperative complications has been reported. Moreover, there is ongoing debate regarding the indications and limitations of this flap. In this study, we confined the flap design to the supraclavicular fossa, considering flap vascularity and in an effort to minimize donor site morbidity. Between 2014 and 2023, we performed supraclavicular flap reconstruction in 3 cases of cervical skin defects and 1 case of a pharyngeal mucosal defect. The average defect and flap sizes were 7×3.9 cm and 11.5×4.4 cm, respectively. The lower border of the flap remained above the clavicle, and the lateral border did not exceed the acromioclavicular joint. When the flaps were transferred using the transposition method, the angle of transposition was limited to <90 degrees. When the VY advancement or turnover method was selected, we paid attention to the tension-free flap inset. We successfully reconstructed the defects without flap-related complications, and donor site scars were inconspicuous in all patients. In conclusion, we believe that confining the flap design to the supraclavicular fossa, limiting the indications of this flap to the reconstruction of medium-sized defects, and using tension-free flap insets are important for the successful application of this flap.

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Source
http://dx.doi.org/10.1097/SCS.0000000000010483DOI Listing

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