A study of the use of the supraclavicular artery flap for resurfacing of head, neck, and upper torso defects

Abstract

The head and neck region is an aesthetically demanding area to resurface because of its high visibility. Tissue defects in this area often require distant flaps or free flaps to achieve an aesthetically acceptable result. The use of the Supraclavicular artery flap represents an extremely versatile and useful option for the resurfacing of head, neck and upper torso defects. Furthermore, islanding the flap gives it a wide arc of rotation and the color and texture match is superior to that of free flaps harvested from distant sites. In our study, we used the flap (both unexpanded and expanded) predominantly for resurfacing neck defects resulting from the release of post-burn contractures. However, its applicability in other indications would also be similar. Except one, all our flaps survived almost completely and the post-operative morbidity was very low. We conclude that the supraclavicular artery flap not only provides a reasonably good color and texture match but also maintains the multi-directional activity in the neck region.

Reconstruction of post burns facial contractures and deformities: an Indian perspective

“…Several published studies have described a similar frequent involvement of younger individuals. [9][10][11] We had equal incidence in males and females which is similar to study by Paul et al 9 Flame burns were the commonest underlying type of burn injury in our study. Flame burns most commonly resulted from accidents due to leakage of natural gas used as domestic fuel for heating/cooking purposes, to clothing catching fire in the kitchen, to accidents with LPG gas cylinders, and to exploding CNG cylinders in vehicles.…”

Supraclavicular Artery Island Flap: Relation Between Length and Distal End Necrosis

“…Loghmani et al in a study with 41 flaps, where the range of flap size was 18 ± 6 cm in length with 3 cases of distal necrosis, had also found that the supraclavicular flap could be safely elevated, provided it was within 20 x 10 cm [36]. On the other hand, Telang et al's study found that the supraclavicular flap could be safely elevated within the dimensions of 20 × 10 cm, and the use of tissue expansion greatly amplified the total area available [37]. The results in the above discussed 5 articles strongly support our results that the flaps of 23 cm and above correlate with distal necrosis.…”

“…From the literature review of supraclavicular flaps for head and neck reconstruction in PubMed search engine, 26 articles [1,2,4,[11][12][13][14][15][16][17]19,20,[23][24][25][26]28,29,31,[33][34][35][36][37][38][39][40] were found that had used supraclavicular flaps for head and neck reconstruction and had clearly stated the length of flaps and their rate of necrosis ( Table 2). The rate of necrosis varied according to the size of the flaps, and only a few of the published articles clearly associated the rate of necrosis with the definite length of the flaps.…”

Vascularized Lymph Node Transfer for Lymphedema

“…A flap based on the supraclavicular branch of the transverse cervical artery was first described by Kazanjian and Converse in 1949. 31,32 The flap was used sparingly until the 1990s, when cadaveric studies by Pallua et al resulted in refinement of the flap that increased its reliability and led to its recent resurgence for head and neck reconstruction, and more recently, for VLNT 33,34 (►Fig. 2).…”