Summary
The supraclavicular island flap has been widely used in head and neck reconstruction,
providing an alternative to the traditional techniques like regional or free flaps,
mainly because of its thin skin island tissue and reliable vascularity. Head and neck
patients who require large reconstructions usually present poor clinical and healing
conditions. An early experience using this flap for late-stage head and neck tumour
treatment is reported.
Forty-seven supraclavicular artery flaps were used to treat head and neck oncologic
defects after cutaneous, intraoral and pharyngeal tumour resections. Dissection time,
complications, donor and reconstructed area outcomes were assessed.
The mean time for harvesting the flaps was 50 min by the senior author. All donor
sites were closed primarily. Three cases of laryngopharyngectomy reconstruction developed
a small controlled (salivary) leak that was resolved with conservative measures. Small
or no strictures were detected on radiologic swallowing examinations and all patients
regained normal swallowing function. Five patients developed donor site dehiscence.
These wounds were treated with regular dressing until healing was complete. There
were four distal flap necroses in this series. These necroses were debrided and closed
primarily.
The supraclavicular flap is pliable for head and neck oncologic reconstruction in
late-stage patients. High-risk patients and modified radical neck dissection are not
contraindications for its use. The absence of the need to isolate the pedicle offers
quick and reliable harvesting. The arc of rotation on the base of the neck provides
adequate length for pharyngeal, oral lining and to reconstruct the middle and superior
third of the face.
Keywords
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Article info
Publication history
Published online: June 04, 2012
Accepted:
April 30,
2012
Received:
June 27,
2011
Footnotes
☆Presented at the 22nd Brazilian Head and Neck Society Meeting in Fortaleza, Brazil, September 2, 2009, and the 47th Congresso Brasileiro de Cirurgia Plastica in Vitoria, Brasil November 11 through 15, 2010.
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
