Supraclavicular Artery Flap for Head and Neck Oncologic Reconstruction: An Emerging Alternative

Aim. Head and Neck oncologic resections often leave complex defects which are challenging to reconstruct. The need of the hour is a versatile flap which has the advantages of both a regional flap (viz. reliable and easy to harvest) and a free flap (thin, pliable with good colour match). In this a study we assessed the usefulness of the supraclavicular artery flap in head and neck oncologic defects.Materials and Method. The flap was used as a pedicled fasciocutanous and was based on the transverse supraclavicular artery. We assessed this reconstructive option for complications as well as its and functional out comes.Results. Eleven cases underwent supraclavicular artery flap between 20011-2012 of which 5 were males and 6 females. Mean defect size was 5 cm × 6 cm. Nine donor sites were closed primarily and 1 required split skin grafting. We encountered one complete flap loss which was attributed to a band of constricting skin bridge over the vascular pedicle in a defect involving lateral third of midface. Two patient developed pharyngeocutaneous fistula (without flap loss) out of 3 patients who underwent augmentation pharyngoplasty post Near total laryngectomy.Conclusion. Supra clavicular artery flap is a thin versatile, reliable, easy to harvest, with good cosmetic and functional outcome at both ends (recipient and donor) for reconstructing head and neck oncologic defects.

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Supraclavicular artery flaps for head and neck reconstruction: a prospective study

International Surgery Journal ◽

10.18203/2349-2902.isj20203794 ◽

2020 ◽

Vol 7 (9) ◽

pp. 3060

Author(s):

Surya Rao Rao Venkata Mahipathy ◽

Alagar Raja Durairaj ◽

Narayanamurthy Sundaramurthy ◽

Anand Prasath Jayachandiran

Keyword(s):

Head And Neck ◽

Neck Region ◽

Free Tissue Transfer ◽

Head And Neck Reconstruction ◽

Head And Neck Region ◽

Complex Anatomy ◽

Reconstructive Option ◽

Good Cosmetic ◽

A Prospective Study ◽

Split Skin

Reconstruction of defects of the head and neck remains a challenge to the reconstructive surgeon. This is due to the complex anatomy of the region as well as the age and comorbidities of the patients, which prevent the use of free tissue transfer as the primary tool of reconstruction. The supraclavicular artery (SCA) island flap is a well vascularised tissue and provides a thin and pliable skin for cutaneous and mucosal defects of the head and neck region. Here, we had done this flap for eight patients with no major complications and hence, we concur that it is a safe, reliable and versatile reconstructive option for these defects. The study period was from January 2015 to June 2016 where we operated on 8 patients, 5 for post burn contracture neck and 3 for post oncologic resection. The flap was used as a pedicled fascio-cutaneous and was based on the transverse supraclavicular artery. Eight cases underwent supraclavicular artery flap of which 5 were males and 3 females. Mean defect size was 15×10 cm. All the donor sites were closed with a split skin graft. One patient had distal necrosis which was managed with debridement and secondary suturing. The supraclavicular artery flap is a thin, versatile, reliable and easy to harvest flap for reconstructing head and neck defects, with good cosmetic and functional outcome.

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Analysis of etiology of loss of skin in lower limb and its reconstructive options

International Surgery Journal ◽

10.18203/2349-2902.isj20203779 ◽

2020 ◽

Vol 7 (9) ◽

pp. 2976

Author(s):

Abhishek Devare ◽

Arun Bhatnagar

Keyword(s):

Lower Limb ◽

Skin Grafting ◽

Medical College ◽

Split Skin Grafting ◽

Reconstructive Option ◽

Skin Loss ◽

Lower Extremity Reconstruction ◽

Common Etiology ◽

Gandhi Medical College ◽

Split Skin

Background: The goal of lower extremity reconstruction in cases of skin loss is the coverage of defects and open wounds of the leg, so that they resume their life and prevent the deformity or amputation. Skin loss is either managed by dressings or surgically providing skin cover in the form of skin graft or flap.Methods: This was a prospective, observational hospital based study which involved 100 patients who were admitted in the ward with a diagnosis of skin loss in lower limb in Department of General Surgery and Department of Plastic surgery, Gandhi medical college and associated Hamidia Hospital, Bhopal, Madhya Pradesh from October 2017 to July 2019. Based upon history, clinical and local examination of the wound, necessary investigations, the plan of management, reconstructive procedure was done. The results were compared after one follow up.Results: The patients suffering were commonly males between 18-29 years and mostly due to trauma. Initial management of wounds with skin loss in lower limb was debridement and dressings. Commonly involved anatomical area was below knee area upto both malleoli. Reconstructive measures were commonly undertaken between 3-7 days. The commonest reconstructive option was split skin grafting. Commonly flap used was perforator based flap and local transposition flap.Conclusions: It can be concluded that the most common etiology responsible for the loss of skin in lower limb is trauma and the most used reconstructive measure in skin loss of lower limb is split skin grafting. Flap coverage acts as the best modality of reconstruction.

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Faculty Opinions recommendation of Randomized clinical trial of donor-site wound dressings after split-skin grafting.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717995277.793475234 ◽

2013 ◽

Author(s):

Marian Northington

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Donor Site ◽

Skin Grafting ◽

Wound Dressings ◽

Split Skin Grafting ◽

Split Skin

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MANAGEMENT OF POST BURN CONTRACTURE OF NECK IN A TERTIARY BURN CARE CENTRE

10.36106/ijsr/2601210 ◽

2021 ◽

pp. 33-35

Author(s):

Nangineedi Nagaprasad ◽

Karthik G B

Keyword(s):

Surgical Planning ◽

Skin Grafting ◽

Burn Care ◽

Split Skin Grafting ◽

Contracture Release ◽

Common Problems ◽

A Prospective Study ◽

Split Skin ◽

Burn Contractures

Background: Post burn contracture is one of the most common problems in our country and usually seen in lower socio-economic people. Burn contractures of the neck can produce a signicant impact on quality of life by reducing a patient's ability to perform activities of daily living Methods: A prospective study was conducted with a sample size of 30 patients with post burn neck contracture conducted for a duration of 24 months. After meticulous surgical planning, patients underwent contracture release and split skin grafting/z-plasty followed by rigorous splintage and physiotherapy. Majority of the patients were in the age group of 11-30 years (63%).70% of the Results: patients sustained burns in the range of 21-40% and 80% were due to ame burns.46.66% (14) of patients had severe contracture while 13.33% (4) had extensive mento-sternal adhesions. 90% of the patients underwent release + SSG while 10% underwent z-plasty. Postoperatively cervico-mental angle of 100-120 degrees was achieved Skin grafting is a simple, reliable and safe operation however postoperative splinting is n Conclusion: ecessary. The use of skin grafts continues to deliver excellent results with adequate restoration of cervico-mental angle.

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