Initial experience with the superficial circumflex iliac artery perforator (SCIP) flap for extremity reconstruction in Caucasians

Kueckelhaus, Maximilian; Gebur, Nils; Kampshoff, David; Hiort, Mirkka; Varnava, Charalampos; Harati, Kamran; Hirsch, Tobias; Wiebringhaus, Philipp

doi:10.1016/j.bjps.2021.05.069

Cited by 8 publications

(4 citation statements)

References 10 publications

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“…The BMIs of our patients were lower compared with patients in some other studies. [23][24][25][26] It is likely that the skin inferior and lateral to the anterior superior iliac spine is not as thin in patients with higher BMI, and therefore, more studies in patients with higher BMIs are required to confirm our findings.…”

Section: Discussionmentioning

confidence: 69%

An Easy Way to Harvest Super-thin SCIP flap with Long Pedicle: Reappraisal of the Inferolateral Branches of SCIA

Zhang

Zeng

2023

Plastic &Amp; Reconstructive Surgery

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Summary: Despite being the first free flap used in reconstructive surgery, the groin flap slowly fell out of fashion because of its short pedicle length, small vessel diameter, variable vascular anatomy, and bulkiness. Over the years, the authors have found that perforators consistently exist inferolateral to the deep branch of the superficial circumflex iliac artery (SCIA), forming an F configuration with the main branch. The authors propose a new type of superficial circumflex iliac artery perforator (SCIP) flap design based on the perforators derived from these inferolateral branches of the SCIA. These perforators have the advantage of anatomic consistency and can be easily found by making an exploratory incision 2 cm caudal to the inguinal ligament. The perforators of the inferolateral branches extend directly into the dermal plexus, and thus can yield superthin flaps without microdissection defatting. Retrograde dissection allows the surgeon to elongate the pedicle to include a section or full length of the SCIA as needed and involving minimal muscle dissection. SCIP flaps harvested based on the perforators of the inferolateral branches of the SCIA were used successfully for six head and neck reconstructions and two trunk reconstructions with no major complications, including flap loss or lymphedema. The best indications for SCIP flaps based on the inferolateral branches of the SCIA are superficial soft-tissue defects that do not require much volume replacement.

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Section: Discussionmentioning

confidence: 69%

An Easy Way to Harvest Super-thin SCIP flap with Long Pedicle: Reappraisal of the Inferolateral Branches of SCIA

Zhang

Zeng

2023

Plastic &Amp; Reconstructive Surgery

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“…In this case, the free Groin flap may be difficult to use because it is relatively short and has a small diameter. 7,25,26 Iida et al 2 used a sensory superficial circumflex iliac perforator flap to repair facial defects. The same authors reported that FIGURE 7.…”

Section: Discussionmentioning

confidence: 99%

“…However, vascular structures close to the recipient area may not be available after crush injury. In this case, the free Groin flap may be difficult to use because it is relatively short and has a small diameter 7,25,26 . Iida et al 2 used a sensory superficial circumflex iliac perforator flap to repair facial defects.…”

Section: Discussionmentioning

confidence: 99%

The Pedicled Sensate Osteocutaneous Groin Flap for Reconstruction of the Forearm and Hand

Turan

2023

Ann Plast Surg

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Background The groin flap is axial pedicled and versatile. Until now, this flap has been used with many modifications for the reconstruction of forearm and hand defects. However, this flap has not been used in forearm, hand, and thumb reconstruction as a pedicled sensate osteocutaneous flap. In this study, a pedicled sensate osteocutaneous groin flap was used for the reconstruction of composite tissue defects on the forearm, hand, and thumb. Patients and Methods A pedicled sensate osteocutaneous groin flap was used to reconstruction composite tissue defects on the forearm, hand, and thumb in 7 patients. The mean age of the patients was 42 years. The defects were located on the dorsal surface of the forearm and hand in 2 patients, the dorsal surface of the hand and finger in 2 patients, and the thumb in 3 patients. The dimensions of the flap skin paddle ranged from 7 × 11 cm to 8 × 23 cm, and the dimensions of the bone component ranged from 1 × 1.5 × 3.5 cm to 1 × 1.5 × 5 cm. The mean follow-up duration was 26 months. Results All the flaps survived. Flap debulking was performed using 3 flaps. Sensory recovery in the flaps was completed approximately 18 months after the first operation. When the results of static 2-point discrimination test and Semmes-Weinstein monofilament test were evaluated at 18 months postoperatively, it showed that protective sensation was obtained. Except for 1 patient, motion restriction did not develop in the wrist, elbow, or shoulder joints. An acceptable aesthetic result, minimal donor site deformity, and protective sensation were obtained in all patients. Conclusions The pedicled sensate osteocutaneous groin flap can be safely used in the reconstruction of forearm and hand composite tissue defects that do not have available vascular structures for free flaps in the recipient area and in thumb reconstruction where toe transfer and pollicization cannot be performed.

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“…However, in scenarios necessitating extensive soft tissue reconstruction, particularly for ‘‘long and narrow’’ wound defects, the limitations of a freestyle flap relying on a singular arterial supply may become apparent. This constraint may impede the ability to harvest a sufficient area while ensuring flap viability, thereby potentially compromising the reconstructive outcome [ 4 – 8 ]. To optimize the benefits associated with the ilioinguinal flap and enhance skin utilization, we have innovatively designed a compound perforator flap based on the ilioinguinal region.…”

Section: Introductionmentioning

confidence: 99%

Repair of a “long and narrow” skin defect of the upper extremity with a modified design of a compound SCIP flap: a series of 12 cases

Wang,

Shi,

Zeng

et al. 2024

Eur J Med Res

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Background Large skin lesions of the upper extremity tend to be ‘‘long and narrow’’ in shape, and the currently used repair and reconstruction protocols still have some drawbacks, including difficulty in closure of the donor area, poor cosmetic appearance of the donor and recipient areas, and low flap survival rates. The ilioinguinal flap has been more widely used for repair and reconstruction of various complex conditions. In order to improve the versatility of the flap design and to achieve better aesthetic results, we report a study on the improved design of Compound SCIP flap for repairing "long and narrow" large skin defects of the upper extremity by using a modified design of the ilioinguinal flap for the procurement of perforating blood vessels and flap excision. Methods From April 2005 to August 2015, a total of 12 patients underwent this modified design procedure, in which the anterior branch of the fourth lumbar artery or the posterior intercostal artery was selected to provide blood supply for the perforator flap together with the superficial branch of the superficial iliac artery to meet the blood supply needs of the flap for the one-time repair of a large "long and narrow" skin defect in the upper limb. Patient demographics, flap characteristics, and associated complications were retrospectively analyzed. Results 3 females and 9 males were included in this study, the mean age of the patients was 31.7 years (range, 22–44 years), the mean follow-up period was 15.3 ± 5.6 months (range, 7–24 months), and all patients had complete closure of the defect site and donor area, and all flaps survived. Conclusions The Compound SCIP flap presents some advantages in repairing 'long and narrow' skin defects in the upper limb. While ensuring the survival rate of the elongated ilioinguinal flap, it amplifies the benefits of the ilioinguinal flap and enhances skin utilization. This can serve as a beneficial choice for repairing 'long and narrow' skin defects in the upper limb.

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Initial experience with the superficial circumflex iliac artery perforator (SCIP) flap for extremity reconstruction in Caucasians

Cited by 8 publications

References 10 publications

An Easy Way to Harvest Super-thin SCIP flap with Long Pedicle: Reappraisal of the Inferolateral Branches of SCIA

An Easy Way to Harvest Super-thin SCIP flap with Long Pedicle: Reappraisal of the Inferolateral Branches of SCIA

The Pedicled Sensate Osteocutaneous Groin Flap for Reconstruction of the Forearm and Hand

Repair of a “long and narrow” skin defect of the upper extremity with a modified design of a compound SCIP flap: a series of 12 cases

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