Defect classification and reconstruction algorithm for patients with tracheostomy using the tunneled supraclavicular artery island flap

Abstract

The proposed classification and treatment algorithm provides a structured approach to a successful surgical treatment of this complex condition.

The Supraclavicular Artery Flap: A Versatile Flap for Neck and Orofacial Reconstruction

“…It was a branch of the transverse cervical artery in 91% of anatomic dissections, arising from the suprascapular artery in fewer than 9% of cases (Table 1). [1][2][3][4][5]7,[11][12][13][14][15][16][17][18][19][20] Of the 146 anatomic dissections, only 2 (1.4%) were supraclavicular artery anomalies. The distance between the sterno- …”

“…The supraclavicular flap has been used for the coverage of defects over the sternum, neck, trachea, retroauricular area, cheek, and oral cavity. [1][2][3] was the first to describe the supraclavicular flap in 1979; this flap was subsequently popularized by Pallua and Wolter, 1 Chiu et al, 2 Pallua and Demir, 3 and Vinh et al 5 The pedicled supraclavicular flap is a very reliable flap, although some investigators have noted rare vascular anomalies that may lead to flap complications. Vinh et al 5 reported the use of the posterior circumflex humeral artery to supercharge large flaps harvested beyond the vascular territory of the supraclavicular flap.…”

“…[1][2][3][4][5]7,[11][12][13][14][15][16][17][18][19][20] A concise compilation of the surgical landmarks, modifications, uses, common complications, and anomalies of the supraclavicular artery flap has not been performed previously. The use of this flap has not been described previously from sub-Saharan Africa; the author sought to evaluate the suitability of its use in an African population, although no cadaveric supraclavicular artery flap studies have been reported in this population.…”

The Supraclavicular Artery Flap for Lateral Skull and Scalp Defects: Effective and Efficient Alternative to Free Tissue Transfer

“…5 This flap was subsequently popularized in head and neck reconstruction by others including Pallua and Magnus Noah and Chiu et al 6,7 The SCAF has been described for multiple sites of reconstruction including oral cavity, trachea, pharynx, and skin defects. [6][7][8] Advantages of the flap are the ease of harvest, minimal donor site morbidity, and lack of microvascular anastomosis.…”

Tunneled and Transposed Island Flaps in Facial Reconstructive Surgery

“…and the postauricular island flap (flip-flop-flap) has been frequently discussed in the repair of anterior auricular defects in which skin and cartilage have been excised [16][17][18]. Of course, tunneled flaps are well-known techniques in reconstructive facial surgery, and even very large facial defects can be repaired with flaps harvested from remote sites and tunneled under the remaining facial skin between the flap's donor site and the primary surgical defect 19,20. …”