title: Supraclavicular artery island flap (SCAIF): a rising opportunity for head and neck reconstruction.
abstract: Over the last 20 years, free flaps have represented the gold standard for moderate to large head and neck reconstruction. However, regional flaps continue to evolve and still play an important role in a reconstructive surgeon's armamentarium, especially for the more delicate patients who would certainly benefit from simpler surgical procedures. The supraclavicular artery island flap (SCAIF) is a pedicled flap that has recently gained great popularity for reconstruction of most head and neck sites, because of its unusual versatility and wide arc of rotation. SCAIF is a fasciocutaneous flap that is very reliable and both easy and quick to harvest. It is pedicled on the supraclavicular artery, which is a branch of the transverse cervical artery. Between October 2012 and July 2015, at Ospedale San Raffaele (Milan, Italy) and Policlinico San Matteo (Pavia, Italy), we used the SCAIF procedure on 14 patients with cervical and facial skin, oral cavity, oropharyngeal, and hypopharyngeal defects after oncologic surgery or as revision surgery after free-flap failure. The presence of the supraclavicular artery was demonstrated preoperatively by computed tomography angiography. Harvesting time never exceeded 50 min. Functional outcomes were excellent, and the donor site was always closed. We reported only one case of tip desquamation, which was treated conservatively, and two cases of partial flap necrosis, which required revision surgery. In our opinion, SCAIF should be considered to be a valid alternative to free-flap reconstruction, especially for facial and cervical skin, floor-of-mouth, and hypopharyngeal defects; oropharyngeal defects may be harder to reconstruct.
authors.affiliation: Otolaryngology Service, Head and Neck Department, "San Raffaele" Hospital, "Vita-Salute" University, Via Olgettina 60, 20123, Milan, Italy. giordano.leone@hsr.it.
authors.forename: Leone
authors.initials: L
authors.lastname: Giordano
authors.affiliation: Otolaryngology Service, Head and Neck Department, "San Raffaele" Hospital, "Vita-Salute" University, Via Olgettina 60, 20123, Milan, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Di Santo
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, IRCCS Policlinico S. Matteo Foundation, University of Pavia, P.le Golgi 2, 27100, Pavia, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Occhini
authors.affiliation: Otolaryngology Service, Head and Neck Department, "San Raffaele" Hospital, "Vita-Salute" University, Via Olgettina 60, 20123, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Galli
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, IRCCS Policlinico S. Matteo Foundation, University of Pavia, P.le Golgi 2, 27100, Pavia, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Bertino
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, IRCCS Policlinico S. Matteo Foundation, University of Pavia, P.le Golgi 2, 27100, Pavia, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Benazzo
authors.affiliation: Otolaryngology Service, Head and Neck Department, "San Raffaele" Hospital, "Vita-Salute" University, Via Olgettina 60, 20123, Milan, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Bussi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D062109:Dermatologic Surgical Procedures; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D013348:Subclavian Artery / Q000601:surgery; D013524:Surgical Flaps / Q000098:blood supply*; D016896:Treatment Outcome
keywords: Alternative to free flaps; Head and neck reconstruction; Pedicled flap; Supraclavicular artery island flap