Objective: To describe the supraclavicular artery island (SAI) flap as an alternative flap for reconstruction of cervicofacial defects.
Study design: Case series with chart review.
Setting: Academic, tertiary referral center.
Subjects and methods: Twenty-two patients with defects of the face, temporal bone, and neck were reconstructed with an SAI flap. Each defect was deemed unsuitable for primary or local flap closure and would require regional or free tissue transfer. Outcome measures included size and location of the defect, time to raise the flap, flap size and viability, and complications. Mean follow-up was 7.4 months (range, 1-31 months). Statistical analysis was performed using SAS 9.1 (SAS Institute, Cary, North Carolina).
Results: Defects of the cervical skin (n = 10), face (n = 8), and temporal bone (n = 4) were reconstructed. Mean flap dimensions were 6.1 cm (range, 5-7 cm) wide and 21.8 cm (range, 16-28 cm) long. The proximal portion of the flap was deepithelialized to match the defect, resulting in a mean skin paddle length of 9.6 cm (range, 5-18 cm). Minor donor site dehiscence occurred in 3 patients. Partial skin flap necrosis occurred in 2 patients, while 1 patient had complete loss of the skin paddle. There was no statistical correlation between flap necrosis and flap length (P = .3, χ(2)) or defect location (P = .13, χ(2)).
Conclusion: The SAI flap is a viable alternative to cervicofacial advancement or microvascular reconstruction of cervicofacial defects in select cases. This flap is reliable, easy to harvest, and versatile, and it provides a good color match for cervicofacial defects.
Keywords: SAI flap; cervicofacial reconstruction; head and neck reconstruction; supraclavicular artery island flap.