Versatility of the Supraclavicular Flap in Head and Neck Reconstruction

Eplasty. 2020 Jun 5:20:e7. eCollection 2020.

Abstract

Objective: Head and neck oncologic resections often leave intricate defects whose reconstruction remains a challenge. The pedicled supraclavicular artery perforator flap is an emerging option, and its applicability in head and neck reconstruction is gaining popularity. Methods: A retrospective analysis of patients regarding medical history, surgical indication, surgical technique, postoperative complications, and outcomes was carried out on all patients admitted to undergo pedicled supraclavicular artery perforator flap reconstruction within our institution. Results: Nine pedicled supraclavicular artery perforator flap reconstructions were performed. Surgical indications were 3 pharyngocutaneous fistulas, 2 tracheoesophageal fistulas, 2 cutaneous defects, 1 immediate pharyngoesophageal reconstruction, and 1 cutaneous and intraoral defect. All flaps survived completely. Excluding one patient who required a second flap due to plate reexposure, the remaining functional and esthetic outcomes were good. Conclusions: The pedicled supraclavicular artery perforator flap is reliable, is quick to harvest, and entails minimal donor site morbidity. Also, it is thin, is pliable, and has a wide arc of rotation, making it extremely versatile. It is an option that should be added to the spectrum of solutions of any head and neck reconstructive surgeon.

Keywords: head and neck reconstruction; pharyngocutaneous fistula; pharyngoesophageal reconstruction; supraclavicular artery perforator flap; tracheoesophageal fistula.