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Otolaryngol Head Neck Surg. 2013 Jun;148(6):941-8. doi: 10.1177/0194599813476670. Epub 2013 Apr 3.

Supraclavicular artery island flap (SCAIF) vs free fasciocutaneous flaps for head and neck reconstruction.

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  • 1Division of Plastic & Reconstructive Surgery, Harbor-UCLA Medical Center, Torrance, California 90509, USA. drjay@plasticsurgery.la

Abstract

OBJECTIVE:

At our institution, the supraclavicular artery island flap (SCAIF) has become a reliable option for fasciocutaneous coverage of complex head and neck (H&N) defects. We directly compare the outcomes of reconstructions performed with SCAIFs and free fasciocutaneous flaps (FFFs), which have not been reported previously.

STUDY DESIGN:

Retrospective chart review.

SETTING:

Tertiary academic medical center.

SUBJECTS AND METHODS:

Retrospective review of consecutive single-surgeon H&N reconstructions using fasciocutaneous flaps over 5 years. Reconstructions were divided into 2 groups: SCAIFs and FFFs. Patient demographics, surgical parameters, and outcomes were compared statistically between groups.

RESULTS:

Thirty-four flaps were used in H&N reconstruction (18 SCAIFs and 16 FFFs). There was no difference in patient demographics, distribution of defects, or follow-up (SCAIF 9.2 vs FFF 15.13 months, P = .65) between the 2 groups. The SCAIFs were larger than the FFFs (164.6 ± 60 vs 111 ± 68 cm(2), P < .05) and had shorter total operative times (588 ± 131 vs 816 ± 149 minutes, P < .05). Intensive care unit (ICU) length of stay was shorter for the SCAIF vs the FFF group (1.8 vs 5.6 days, P < .05). Overall morbidity was not significantly different (SCAIF 39% vs FFF 44%, P = NS).

CONCLUSION:

The SCAIF is a technically simpler and equally reliable sensate fasciocutaneous flap for H&N reconstruction with comparable outcomes, shorter operative time, less ICU stay, and no need for postoperative monitoring when compared with using FFFs. It should be considered a first-choice reconstructive option for complex H&N defects.

KEYWORDS:

free fasciocutaneous flaps; head and neck reconstruction; outcomes; pedicled flaps; shoulder flap; supraclavicular artery island flap

PMID:
23554114
[PubMed - indexed for MEDLINE]
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