title: Supraclavicular artery island flap (SCAIF) vs free fasciocutaneous flaps for head and neck reconstruction.
abstract: OBJECTIVE
  At our institution, the supraclavicular artery island flap (SCAIF) has become a reliable option for fasciocutaneous coverage of complex head and neck (H&N) defects. We directly compare the outcomes of reconstructions performed with SCAIFs and free fasciocutaneous flaps (FFFs), which have not been reported previously.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Tertiary academic medical center.
  
  
  METHODS
  Retrospective review of consecutive single-surgeon H&N reconstructions using fasciocutaneous flaps over 5 years. Reconstructions were divided into 2 groups: SCAIFs and FFFs. Patient demographics, surgical parameters, and outcomes were compared statistically between groups.
  
  
  RESULTS
  Thirty-four flaps were used in H&N reconstruction (18 SCAIFs and 16 FFFs). There was no difference in patient demographics, distribution of defects, or follow-up (SCAIF 9.2 vs FFF 15.13 months, P = .65) between the 2 groups. The SCAIFs were larger than the FFFs (164.6 ± 60 vs 111 ± 68 cm(2), P < .05) and had shorter total operative times (588 ± 131 vs 816 ± 149 minutes, P < .05). Intensive care unit (ICU) length of stay was shorter for the SCAIF vs the FFF group (1.8 vs 5.6 days, P < .05). Overall morbidity was not significantly different (SCAIF 39% vs FFF 44%, P = NS).
  
  
  CONCLUSIONS
  The SCAIF is a technically simpler and equally reliable sensate fasciocutaneous flap for H&N reconstruction with comparable outcomes, shorter operative time, less ICU stay, and no need for postoperative monitoring when compared with using FFFs. It should be considered a first-choice reconstructive option for complex H&N defects.
authors.affiliation: Division of Plastic & Reconstructive Surgery, Harbor-UCLA Medical Center, Torrance, California 90509, USA. drjay@plasticsurgery.la
authors.forename: Jay W
authors.initials: JW
authors.lastname: Granzow
authors.forename: Ahmed
authors.initials: A
authors.lastname: Suliman
authors.forename: Jason
authors.initials: J
authors.lastname: Roostaeian
authors.forename: Adam
authors.initials: A
authors.lastname: Perry
authors.forename: J Brian
authors.initials: JB
authors.lastname: Boyd
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply*; D006084:Graft Rejection; D006085:Graft Survival; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D061646:Operative Time; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D016038:Skin Transplantation / Q000379:methods*; D013348:Subclavian Artery / Q000601:surgery / Q000637:transplantation; D040521:Subcutaneous Tissue / Q000601:surgery / Q000637:transplantation*; D013524:Surgical Flaps / Q000098:blood supply*; D015996:Survival Rate; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
keywords: free fasciocutaneous flaps; head and neck reconstruction; outcomes; pedicled flaps; shoulder flap; supraclavicular artery island flap