title: Resurfacing large skin defects of the face and neck with expanded subclavicular flaps pedicled by the thoracic branch of the supraclavicular artery.
abstract: BACKGROUND
  Supraclavicular flaps had been widely used as pedicled flaps to reconstruct face and neck defects. However, the size of this traditional flap was limited even after expansion. In this study, we present a flap pedicled by the thoracic branch of supraclavicular artery (TBSA). The flap is located at the subclavicular region, and has the advantage of large dimension, matching colour and thin thickness.
  
  
  METHODS
  In this series, 24 patients with ages ranging between 3 and 49 years (30 flaps with six patients in bilateral fashion) were treated in the authors' institution.
  
  
  RESULTS
  The maximum size of the flap was 25 cm × 25 cm, whereas the minimum size was 15 cm × 10 cm. The average size of the flaps was 241.1 ± 95.7 cm(2). Twenty-six flaps (86.7%) survived completely. Total flap loss was seen in one patient (3.3%) and was treated with reverse harvesting skin graft. Partial flap necrosis occurred in three flaps (10.0%). Through a mean time of 10-month follow-up, the colour and the texture of the flaps matched with the recipient area. No conspicuous flap contracture was observed.
  
  
  CONCLUSIONS
  This expanded subclavicular flap pedicled by the TBSA has proved to be a promising method with satisfactory outcome and high success rate.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, PR China.
authors.forename: Feng
authors.initials: F
authors.lastname: Xie
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.forename: Qingfeng
authors.initials: Q
authors.lastname: Li
authors.forename: Shuangbai
authors.initials: S
authors.lastname: Zhou
authors.forename: Tao
authors.initials: T
authors.lastname: Zan
authors.forename: Bin
authors.initials: B
authors.lastname: Gu
authors.forename: Kai
authors.initials: K
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D002056:Burns / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005145:Face / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply; D015626:Tissue Expansion / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods; D055815:Young Adult