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Supraclavicular flap

Christian Welz, Martin Canis, Sabina Schwenk-Zieger, Jennifer L Spiegel, Bernhard G Weiss, Yiannis Pilavakis
PURPOSE: To evaluate whether the pedicled supraclavicular artery island flap (SCAIF) is a sufficient alternative to the fasciocutaneous radial forearm free flap (RFFF) for oral reconstruction in cancer surgery. PATIENTS AND METHODS: The authors designed and implemented a retrospective cohort study composed of all consecutive patients who underwent head and neck reconstruction after cancer surgery at their tertiary university hospital from 2013 to 2016. Demographics and peri- and postoperative information were recorded and statistically analyzed...
March 2, 2017: Journal of Oral and Maxillofacial Surgery
Masashi Kimura, Hiroyuki Ohto, Akio Shibata, Hiroki Yamada, Shusuke Nishiwaki, Masahiro Umemura
Cervical chylomas are rare pseudocystic collections that lack an epithelial lining and arise from the thoracic duct or its tributaries; although they typically develop after neck surgery or trauma, they can arise from unknown causes. Treatment options include not only conservative therapy, such as dietary modification, repeated aspirations, and sclerotherapy, but also include surgical excision. We describe a case of a chyloma in a 64-year-old Japanese woman with squamous cell carcinoma of the gingiva. The chyloma developed following left segmental mandibulectomy with radical neck dissection and reconstruction, using a titanium plate and a pectoralis major myocutaneous flap...
February 2017: Nagoya Journal of Medical Science
H Ismail, A Elshobaky
Anterior cervical contractures of the neck represent a great challenge for plastic and reconstructive surgeons. Necks can be reconstructed with a wide range of surgical techniques, including chimeric flaps, supercharged flap, pre-expanded flaps, "superthin" flaps and perforator flaps. The supraclavicular flap is easy to harvest without the need for free tissue transfer. It provides a relatively large flap for neck resurfacing with tissue very similar to that of the neck. Between January 2013 and March 2015, 20 patients suffering from postburn neck contracture underwent reconstruction with 20 unilateral supraclavicular artery perforator flaps...
September 30, 2016: Annals of Burns and Fire Disasters
Sameep Kadakia, Jay Agarwal, Moustafa Mourad, Sara Ashai, Thomas Lee, Yadranko Ducic
Background The objective of this study was to determine whether there was a difference in complication rate between cutaneous and mucosal defects reconstructed with the supraclavicular artery flap. Methods Retrospective review of postoperative complications in 63 patients from 2008 to 2015 with cutaneous and mucosal head and neck defects following oncologic ablation reconstructed with the supraclavicular flap, with a minimum follow-up duration of 6 months. Of the 63 patients, 38 patients had cutaneous defects, whereas 25 had mucosal defects...
May 2017: Journal of Reconstructive Microsurgery
Norbert Pallua, Bong-Sung Kim
The supraclavicular artery perforator (SAP) flap is a versatile flap for the reconstruction of head and neck defects. Recently, the authors have modified the SAP flap by using an anterior branch of the transverse cervical artery. The anterior SAP flap allows the harvest of a tissue island in the deltopectoral fossa, which is even thinner, is more pliable, and shows a superior color match to the face and neck compared with the original SAP flap. Pre-expansion increases flap size considerably, enabling the coverage of extended defects without the need of microsurgery...
January 2017: Clinics in Plastic Surgery
Baoqiang Song, Jianwu Chen, Xianjie Ma, Yang Li, Juan Zhang, Shuzhong Guo
BACKGROUND: The anterior chest is an excellent donor site for cervicofacial reconstruction. Studies of chest flaps began as early as 1988 at our institution. We identified a new branch of the supraclavicular artery that nourishes the anterior chest, and on the basis of this finding, we created a new flap called the subclavicular flap. Unlike the supraclavicular flap, which is pedicled by the deltoid branch, this flap is primarily pedicled by the thoracic branch, and it shares similar vascular territory with the deltopectoral flap...
December 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Eugene Hze-Khoong Poh, Li-Qun Xu, Xue-Lai Yin, Shu-Kun Shen
PURPOSE: Drawbacks of the conventional supraclavicular overlay of the pectoralis major myocutaneous flap (PMMF) include the resultant unesthetic cervical bulge and the limited cephalad extension that limits its use to mandibular or cervical defects. This study discusses the technique and comparative advantages of a more esthetic subclavicular route through the clavipectoral fascia that allows an increased arc of rotation to reconstruct orofacial defects. MATERIALS AND METHODS: Patients with orofacial defects that were reconstructed with a PMMF through the modified subclavicular route were included in this retrospective cohort study, which aimed to compare the gain in extension accorded through the modified subclavicular tunnel over an initial conventional supraclavicular overlay...
January 2017: Journal of Oral and Maxillofacial Surgery
Baoguo Chen, Huifeng Song, Minghuo Xu, Quanwen Gao
PURPOSE: A high-quality flap is necessary for repairing faciocervical scar contractures. The supraclavicular region and chest wall are the preferred choices for reconstruction. The supraclavicular island flap (SIF) pedicled by the transverse cervical artery (TCA) has been reported. Compared to the traditional SIF flap, another type of flap pedicled by the anterior perforator of transverse cervical artery (ap-TCA) is more convenient for transfer to the faciocervical area. In this article, we use this type of perforator flap and expanded perforator flap to repair the faciocervical contracture...
September 2016: Journal of Cranio-maxillo-facial Surgery
K-L Bruchhage, A Leichtle, B Wollenberg
BACKGROUND: Reconstruction of defects after extirpation of head and neck cancer is a highly challenging and complex surgical undertaking. Commonly used techniques, e.g., the radial forearm flap, the anterior lateral thigh flap, or flaps harvested from the chest-deltopectoral or pectoralis major-share numerous disadvantages, such as donor-site morbidity, poor color matching for cutaneous reconstruction, and excessive tissue bulk. The use of a supraclavicular artery island flap is a long-forgotten but increasingly popular option for reconstruction in the head and neck area...
January 2017: HNO
Si-Lian Fang, Da-Ming Zhang, Wei-Liang Chen, You-Yuan Wang, Song Fan
PURPOSE: The aim of the present clinical study was to evaluate the feasibility of a folded extended supraclavicular fasciocutaneous island flap (SFIF) for full-thickness cheek defect reconstruction following ablative oral cancer surgery. PATIENTS AND METHODS: The nine patients with advanced squamous cell carcinoma of the buccal mucosa were six men and three women, with a mean age of 60.8 years. All patients were treated with surgery including ipsilateral radical neck dissection...
April 2016: Journal of Cancer Research and Therapeutics
Conor M Devine, Timothy M Haffey, Samuel Trosman, Michael A Fritz
OBJECTIVES/HYPOTHESIS: To show that, for patients with few medical comorbidities and at low risk for airway compromise or fistula formation, early discharge after free tissue transfer for head and neck reconstruction is a safe and viable option. STUDY DESIGN: Retrospective chart review. METHODS: A cohort of patients who underwent free tissue transfer for head and neck reconstruction between February 2010 and December 2014 and who were discharged from the hospital by postoperative day 3 were reviewed...
December 2016: Laryngoscope
Andres A Mardonado, Ru Chen, David W Chang
BACKGROUND AND OBJECTIVES: Vascularized lymph node transfer (VLNT) is gaining popularity for treatment of lymphedema. The purpose of this study was to evaluate the flap and the donor site morbidity of the supraclavicular (SC) VLNT. METHODS: A review of a prospective database was performed for patients who had undergone SC VLNT to treat upper or lower extremity lymphedema. Flap and donor site complications were registered for each patient. A detailed technical surgical approach is explained...
January 2017: Journal of Surgical Oncology
Johannes Steinbacher, Ines E Tinhofer, Stefan Meng, Lukas F Reissig, Eva Placheta, Julia Roka-Palkovits, Thomas Rath, Ming-Huei Cheng, Wolfgang J Weninger, Chieh Han Tzou
BACKGROUND: Vascularized lymph node transfer is an effective surgical method in reducing lymphedema. This study provides the first detailed description of the surgical anatomy of the supraclavicular lymph node flap in regard to pedicle length, pedicle diameter, and the number of lymph nodes and their exact location inside the flap. METHODS: Bilateral supraclavicular dissections of nine fresh cadavers (five female) were performed. Before the dissection, the exact number of lymph nodes was determined sonographically by an experienced radiologist, and their distance from the jugular notch was measured...
January 2017: Journal of Surgical Oncology
Leone Giordano, Davide Di Santo, Antonio Occhini, Andrea Galli, Giulia Bertino, Marco Benazzo, Mario Bussi
Over the last 20 years, free flaps have represented the gold standard for moderate to large head and neck reconstruction. However, regional flaps continue to evolve and still play an important role in a reconstructive surgeon's armamentarium, especially for the more delicate patients who would certainly benefit from simpler surgical procedures. The supraclavicular artery island flap (SCAIF) is a pedicled flap that has recently gained great popularity for reconstruction of most head and neck sites, because of its unusual versatility and wide arc of rotation...
December 2016: European Archives of Oto-rhino-laryngology
John Yoo, Tsu-Hui Hubert Low, Samantha Tam, Allison Partridge, S Danielle MacNeil, Anthony C Nichols, Kevin Fung
BACKGROUND: The pedicled adipofascial infraclavicular flap (ICF) is based on the anterior perforator of the supraclavicular artery and supplies the fasciocutaneous tissue of the upper chest. This flap may be used to address neck contour defects and vessel coverage after radical and modified radical neck dissections (MRNDs). METHODS: We described the pedicled adipofascial ICF elevation technique and its use immediately after neck dissections in order to maintain soft tissue volume and vessel coverage...
October 2016: Head & Neck
Neerav Goyal, Kevin S Emerick, Daniel G Deschler, Derrick T Lin, Bharat B Yarlagadda, Debbie L Rich, Marlene L Durand
BACKGROUND: Surgical site infections can adversely affect flaps in head and neck reconstruction. The purpose of this study was to evaluate the risk factors of surgical site infections in supraclavicular artery island flap reconstructions. METHODS: Records of patients undergoing head and neck surgery from 2011 to 2014 with supraclavicular artery island flap reconstruction at a single specialty hospital were reviewed; surgical site infections ≤30 days postoperatively were noted...
April 21, 2016: Head & Neck
Patrick A Gerety, Christopher J Pannucci, Marten N Basta, Amber R Wang, Paul Zhang, Carolyn Mies, Suhail K Kanchwala
OBJECTIVE: Microvascular transfer of lymph node flaps has recently gained popularity as a treatment for secondary lymphedema often occurring after axillary, groin, or pelvic lymph node dissections. This study aimed to delineate the lymph node contents and pedicle characteristics of the supraclavicular (SC) and thoracodorsal (TD)-based axillary flaps as well as to compare lymph node quantification of surgeon vs pathologist. METHODS: SC and TD flaps were dissected from fresh female cadavers...
January 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Elliott D Kozin, Rosh K Sethi, Marc Herr, Mark G Shrime, James W Rocco, Derrick Lin, Daniel G Deschler, Kevin S Emerick
OBJECTIVE: Outcomes of the supraclavicular artery island flap (SCAIF) have not been extensively studied in comparison with free tissue transfer (FTT) flaps for head and neck reconstruction. We hypothesize that the pedicled SCAIF has decreased operating room time, length of stay, time to wound healing of recipient site, complications, and hospital charges as compared with FTT. STUDY DESIGN: Case series with chart review. SETTING: Tertiary care teaching hospital...
January 2016: Otolaryngology—Head and Neck Surgery
Yashan Gao, Yuwen Yuan, Haizhou Li, Bin Gu, Feng Xie, Tanja Herrler, Qingfeng Li, Tao Zan
OBJECTIVE: The thoracic branch of supraclavicular artery (TBSA) flap has been widely used to reconstruct face and neck defects. However, the branches of the supraclavicular artery (SCA) exhibit considerable anatomical variations. The aim of this study was to evaluate and compare the role of contrast-enhanced ultrasound (CEUS) with 3-dimensional (3D) reconstruction and regular color duplex ultrasonography (CDUS) in the preoperative assessment of TBSA flap. METHODS: From May 2009 to October 2013, 20 patients (involving 26 flaps) receiving anterior chest flaps for lower face and neck reconstruction underwent both CDUS and CEUS with 3D reconstruction preoperatively for detecting the TBSAs...
August 2016: Annals of Plastic Surgery
Marc N Busche, Norbert Pallua
No abstract text is available yet for this article.
March 2016: Journal of Reconstructive Microsurgery
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