title: Safety of the supraclavicular artery island flap in the setting of neck dissection and radiation therapy.
abstract: BACKGROUND
  The supraclavicular artery island flap (SAIF) has recently been repopularized as a versatile and reliable option for reconstruction of oncological head and neck defects. Prior ipsilateral neck dissection or irradiation is considered a relative contraindication to its use. The aim of this study was to describe the safety and utility of the SAIF for head and neck reconstruction in the setting of neck dissection and radiation.
  
  
  METHODS
  A retrospective chart review was performed of consecutive SAIF reconstructions at two institutions between May 2011 and 2014. In addition to demographic data, comorbidities, indications, surgical characteristics, data about radiation treatment, and neck dissection were specifically recorded. Donor and recipient site complications were noted. Fisher exact test was performed to analyze if neck dissection or radiation were associated with complications.
  
  
  RESULTS
  A total of 22 patients underwent SAIF reconstruction for an array of head and neck defects. Donor site infection was noted in one patient. Recipient site complications included, wound dehiscence (n = 2), orocutaneous fistula (n = 1), carotid blowout (n = 1), and total flap loss (n = 1). There was no association between prior neck dissection or radiation treatment and flap loss (p = 1.00).
  
  
  CONCLUSIONS
  The SAIF is safe for use in patients who have had an ipsilateral neck dissection involving level IV or V lymph nodes and/or radiation treatment to the neck. It can be used alone or in combination with other flaps for closure of a variety of head and neck defects.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Memorial Sloan-Kettering Cancer Center, New York.
authors.forename: Shantanu N
authors.initials: SN
authors.lastname: Razdan
authors.affiliation: Division of Plastic and Reconstructive Surgery, Memorial Sloan-Kettering Cancer Center, New York.
authors.forename: Claudia R
authors.initials: CR
authors.lastname: Albornoz
authors.affiliation: Division of Plastic and Reconstructive Surgery, Memorial Sloan-Kettering Cancer Center, New York.
authors.forename: Teresa
authors.initials: T
authors.lastname: Ro
authors.affiliation: Division of Plastic and Reconstructive Surgery, Memorial Sloan-Kettering Cancer Center, New York.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Cordeiro
authors.affiliation: Division of Plastic and Reconstructive Surgery, Memorial Sloan-Kettering Cancer Center, New York.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Disa
authors.affiliation: Division of Plastic and Reconstructive Surgery, Memorial Sloan-Kettering Cancer Center, New York.
authors.forename: Colleen M
authors.initials: CM
authors.lastname: McCarthy
authors.affiliation: Division of Plastic and Reconstructive Surgery, Montefiore Medical Center, New York.
authors.forename: Carrie S
authors.initials: CS
authors.lastname: Stern
authors.affiliation: Division of Plastic and Reconstructive Surgery, Montefiore Medical Center, New York.
authors.forename: Evan S
authors.initials: ES
authors.lastname: Garfein
authors.affiliation: Division of Plastic and Reconstructive Surgery, Memorial Sloan-Kettering Cancer Center, New York.
authors.forename: Evan
authors.initials: E
authors.lastname: Matros
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries; D002968:Clavicle / Q000098:blood supply*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000473:pathology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps