Posteriorly Expanded Supraclavicular Artery Flap Can Reach Distant More Reliable and Safe
Abdolreza Rouientan;Alireza Hoseini Sianaki;Hojjat Molae.
Journal Title:Acta Scientific Otolaryngology
Introduction:Head and neck soft tissue reconstruction by supraclavicular flap is interesting, because of thinness and known ana-tomical landmarks. Distal ischemia and flap missing, evoked considerations to reinforce transferred flap in a reliable way. We tried by introducing expanded posterior supraclavicular flap.Patients and Methods: During 8 years, 11 patients with complex facial scars underwent facial skin defect reconstruction by inser-tion of rectangular tissue expander in a properly matched size in the subcutaneous pocket of posterior margin of ipsilateral supracla-vicular area in the first surgery and then removal of tissue expander and prepared flap transfer to resultant recipient defect. All early and delayed donor and recipient site complications analyzed.Results: 11 patients operated in sequential stages and removed scar defects reconstructed by flap. The mean size of involved area was (201.579 +/_ 24.73) cm2, and after about 3.27 months inserted tissue expanders were removed and flaps used to cover defects. The most significant donor site morbidity was mild hypertrophic scar which did not need operation and only one recipient site with wound dehiscence required secondary surgery.Discussion:Supraclavicular artery flap is used traditionally to cover head and neck soft tissue defects. Distant defects are challeng-ing for surgeons to save probable ischemic distal ends. Tissue expansion, especially in posterior part of supraclavicular, not only reinforces vasculature nourishment of flap and diminishes wound problem risks, but also makes flap thinner and more pliable to adjust defects.Conclusion:Supraclavicular artery flap` expansion on posterior area can help reach distally safer and reliable.