Abstract: The Supraclavicular Artery Island Flap (SCAIF) As An Ideal Option In Head & Neck Reconstruction (Plastic Surgery 2012)

Saturday, October 27, 2012: 11:25 AM

Jay W. Granzow, MD, MPH, FACS , Division of Plastic and Reconstructive Surgery, Harbor - UCLA, Torrance, CA

Ahmed S. Suliman, MD , Division of Plastic & Reconstructive Surgery, University of California, Los Angeles, Los Angeles, CA

Jason Roostaeian, MD , Division of Plastic & Reconstructive Surgery, University of California, Los Angeles, Los Angeles, CA

Adam Perry, MD , Division of Plastic & Reconstructive Surgery, University of California, Los Angeles, Los Angeles, CA

J. Brian Boyd, MD, FRCSC , Division of Plastic & Reconstructive Surgery, Harbor-UCLA, Torrance, CA

Presentation PDF file

Background/Objective: At our institution, the Supraclavicular Artery Island Flap (SCAIF) has become a reliable, first-line option for fasciocutaneous coverage of complex Head & Neck defects. Previously, no studies have compared the outcomes of reconstructions performed with SCAIF and free flaps directly.The aim of our study was to compare the outcomes between SCAIF and Free Fasciocutaneous Flaps (FFF) via a single surgeon experience at a County Hospital.

Methods: Retrospective review of a single surgeon experience over 5 yrs of consecutive Head and Neck reconstructions using fasciocutaneous flaps. Osseous reconstructions were excluded. Reconstructions were divided into two groups: SCAIFs versus FFFs. Patient demographics, surgical parameters and outcomes were compared among the two groups and statistical analyses performed.

Results: Thirty-two consecutive fasciocutaneous flaps were used in H&N reconstruction. There were 16 SCAIF flaps and 16 FFFs (12 RFFF, 3 ALT, 1 DIEP). There was no difference in baseline patient demographics between the 2 groups. The distribution of defects was equivalent between the 2 groups (oral cavity, base of tongue, glossectomy, pharyngo-esophageal, cutaneous). The SCAIF group had a significantly larger flap size than the free flap group (169 ± 61 vs. 111 ± 68 cm²p< .05), and shorter total operative times, which included resection, flap reconstruction, and additional procedures performed under the same anesthetic (592 ± 134 vs. 816 ± 149 minutes p< .05). 31% of SCAIFs required skin grafting to the donor site compared to 75% of the FFFs (p<.05). ICU length of stay was shorter for the SCAIF group compared to the FFF group (2 vs. 5.6 days p< .05 ) but there was no difference in total hospital stay (16.9 vs. 18.50 days p=.58). There was no difference in mean follow-up between the 2 groups ( SCAIF 10.24 vs. FFF 15.13 months p=.65). Overall morbidity (total number of complications) was statistically the same between the 2 groups (SCAIF 38% vs. Free Flap 30% NS).

Conclusion: The SCAIF flap is a technically simpler and equally reliable fasciocutaneous flap for Head & Neck reconstruction with comparable outcomes, shorter operative time, less ICU length of stay and no need for postoperative monitoring when compared to using free fasciocutaneous flaps and should be considered as a first-line reconstructive option.

21186 The Supraclavicular Artery Island Flap (SCAIF) As An Ideal Option In Head & Neck Reconstruction