ISLAND FLAP

ROLE OF SUPRACLAVICULAR ARTERY ISLAND FLAP IN COMPLEX FACIAL SOFT TISSUE RECONSTRUCTION: A CLINICAL STUDY

Abstract

Objectives: To determine the role of Supraclavicular Artery Island Flap as an
alternate to local and other regional flaps for complex soft tissue reconstruction of head and neck
defects created by tumor resection, fire arm injuries, and burns. Study Design: A descriptive
clinical experimental study. Place and Duration of Study: From December 2014 to November
2017, at Department of Plastic & Reconstructive Surgery, Dow University of Health Sciences
and Dr. Ruth KM Pfau, Civil Hospital Karachi, Pakistan. Methodology: Pedicle supraclavicular
artery island flap was used to reconstruct facial soft tissue defects. Recipient and donor site
outcomes, functional consequences and complications were assessed. Patients with soft tissue
defects either due to tumor extirpation and supraomohyoid neck dissection, trauma due to
firearm arm and burn were included. Patients with level IV neck dissection or having scarred or
injured supraclavicular areas were excluded. Results: Eighty-Four Supraclavicular Artery Island
flap reconstructions were performed for the reconstruction of lower face defects. Mean age of
patients was 40.7 years. Through-and-through defect involving the oral lining and skin of the
lower face after tumor excision in 78 cases, fire arm injury and burn was the cause in3patients
each. Complete flap failure was 3 (3.5%) and partial flap failure was in 6 (7.1%) patients. Mean
period of follow-up was 11.86 months (range 7-19 months). Conclusion: Supraclavicular Artery
Island Flap is an excellent alternate to other local and regional flaps with impressive recovery,
acceptable skin color match and restoration of anatomic function at recipient site without any
serious complications. Majority of donor sites were closed primarily, and healed without any
major complications.