Acta Scientific Otolaryngology (ASOL) (ISSN: 2582-5550)

Research Article Volume 3 Issue 2

Posteriorly Expanded Supraclavicular Artery Flap Can Reach Distant More Reliable and Safe

Abdolreza Rouientan1, Alireza Hoseini Sianaki2 and Hojjat Molaei3

1Assistant Professor of Plastic and Reconstructive Surgery, Plastic Surgery Department, Shahid Beheshti Medical Science University, Tehran, Iran
2Resident of Plastic and Reconstructive Surgery, Plastic Surgery Department, Shahid Beheshti Medical Science University, Tehran, Iran
3Assistant Professor of Plastic and Reconstructive Surgery, Plastic Surgery Department, Tehran Medical Science University, Tehran, Iran

*Corresponding Author: Hojjat Molaei, Assistant Professor of Plastic and Reconstructive Surgery, Plastic Surgery Department, Tehran Medical Science University, Tehran, Iran.

Received: December 11, 2020; Published: January 23, 2021

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Abstract

Introduction: Head and neck soft tissue reconstruction by supraclavicular flap is interesting, because of thinness and known anatomical 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 insertion of rectangular tissue expander in a properly matched size in the subcutaneous pocket of posterior margin of ipsilateral supraclavicular 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 challenging 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.

Keywords: Reconstruction; Supraclavicular Flap; Tissue Expansion

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References

  1. Ross RJ., et al. “The anatomical basis for improving the reliability of the supraclavicular flap”. Journal of Plastic Reconstructive and Aesthetic Surgery 2 (2014): 198-204.
  2. S Atallaha., et al. “Supraclavicular artery island flap in head and neck reconstruction”. European Annals of Otorhinolaryngology, Head and Neck Diseases 132 (2015): 291-294.
  3. Till FG., et al. “Procedure for a Failed Microvascular Hypopharyngeal Defect Closure in a Tetraplegic Patient”. Annals of Plastic Surgery3 (2011): 245-250.
  4. Granzow JW., et al. “The supraclavicular artery island flap (SCAIF) for head and neck reconstruction: surgical technique and refinements”. Otolaryngology–Head and Neck Surgery6 (2013): 933-940.
  5. Bilal M., et al. “The use of pedicled supraclavicular artery flap in reconstruction of soft tissue defects of the head and neck region”. JKCD2 (2013).
  6. Loghmani S., et al. “The Supraclavicular Flap for Reconstruction of Post-Burn Mentosternal Contractures”. Iranian Red Crescent Medical Journal 4 (2013): 292-297.
  7. Kokot N., et al. “The Supraclavicular Artery Island Flap in Head and Neck Reconstruction Applications and Limitations”. JAMA Otolaryngology–Head and Neck Surgery 11 (2013): 1247-1255.
  8. Herr MW., et al. “The Supraclavicular Artery Flap for Head and Neck Reconstruction”. JAMA Facial Plastic Surgery 2 (2014): 127-132.
  9. Pink R., et al. “Regional Flap in Head and Neck Reconstruction- Part I: Philosophy, Submental and Supraclavicular Flaps”. Dentistry 7 (2017): 433.
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Citation

Citation: Hojjat Molaei., et al. “Posteriorly Expanded Supraclavicular Artery Flap Can Reach Distant More Reliable and Safe".Acta Scientific Otolaryngology 3.2 (2020): 38-41.




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Acceptance rate34%
Acceptance to publication20-30 days
Impact Factor0.871

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