Supra-Clavicular Artery Flap in Head and Neck Reconstruction

Abstract

Background:To study results of supraclavicular
artery flap in head and neck reconstruction in terms
of its reliability, clinical applications, and functional
and aesthetic outcome
Methods: In this descriptive study 71 patients who
got supraclavicular flap reconstruction were
included. When both supra-clavicular areas were
found to be suitable for flap donation, the nondominant
side was selected as the donor site. In case
of patients having only one supraclavicular area
suitable for flap donation, that available donor-site
was used. Pre-operatively, a 10 MHZ hand held
Doppler probe was used to exactly locate and mark
the origin and course of the supraclavicular vessels,
and flap design was outlined on the selected donorsite
according to the analyzed dimensions of the
defect. Per-operatively, the defect was prepared and
its dimensions were mapped out with the help of a
template. The planning in reverse was used to
confirm or correct the flap design already marked.
The flap was elevated and inset into the defect with
a suction drain underneath. The donor site was
widely undermined and closed directly in most of
the cases with another suction drain in place. Where
primary closure was not achievable or considered
unsafe even after wide undermining, the defect was
reduced in size with advancement of the
surrounding skin margins and the residual defect
was split-skin grafted. Postoperatively, patients were
observed for survival of the flap, and any early flap
or donor-site complication. The patients who
underwent release of neck contractures were advised
to wear a Philadelphia neck collar two weeks
postoperatively. At each follow-up, the flap and
donor site were examined for any late complications.
Results: All flaps survived with only 5 flaps having
marginal tip necrosis with acceptable postoperative
course