Reconstruction of Soft Tissue Defect of Lower Extremity With Free SCIA/SIEA Flap

Abstract

Free tissue transfer is the most important means of soft tissue reconstruction for the lower extremity. However, cosmetic results and donor site morbidity are only of secondary concern of lower extremity reconstruction. In our efforts to obtain the best possible outcome for patients, as our first priority we chose free superficial circumflex inferior artery (SCIA)/superficial inferior epigastric artery (SIEA) flap over other free flap options in the soft tissue reconstruction of lower extremity because of some advantages. Over the past 3 year, 25 patients underwent lower extremity reconstruction with free SCIA/SIEA flap (n = 27). Twenty-six of 27 flaps were successful (96%), 6 required emergent postoperative re-exploration of the anastomosis, and 1 failed. Although secondary debulking procedure was performed for some flaps (n = 3), most flaps had acceptable thickness for functional and esthetic outcomes especially in the pretibial, ankle, and foot defect reconstruction with an average of 1-year follow-up. Based on our results, free SCIA/SIEA flap has the following advantages in soft tissue reconstruction of lower extremity: (1) large flaps may be harvested for extensive defect and/or to reach recipient artery for passing zone of injury; (2) if necessary, final flap debulking may be performed by surgical procedure using local anesthesia; (3) the donor site is closed in a similar manner to abdominoplasty incision so that excellent cosmetic result may be achieved.

Free flaps for reconstruction of soft tissue defects in lower extremity: A meta‐analysis on microsurgical outcome and safety

“…Therefore, these three articles were additionally excluded. Finally, 30 articles overlooking 1,356 patients and 1,397 free flaps for lower extremity reconstruction were included in the present meta‐analysis (Table ) …”

Free versus perforator‐pedicled propeller flaps in lower extremity reconstruction: What is the safest coverage? A meta‐analysis

“…The processes of identification, screening, and eligibility were described. A total of 1,802 references of free flap were identified and we included 36 studies that discussed 1,226 free flaps used to treat 1,226 patients (Table ). For the pedicled‐propeller flap, a total of 616 references was identified and we included 19 studies .…”

Sensate superficial inferior epigastric artery flap innervated by the iliohypogastric nerve for reconstruction of a finger soft tissue defect

“…SIEA flap, although not as useful as SCIP flap, is also a useful flap for reconstruction of soft tissue defect . Theoretically, SIEA flap's region is innervated by the T12 nerve and the iliohypogastric nerve (IHN), but no sensate SIEA flap has been reported so far .…”

“…1,2 SIEA flap, although not as useful as SCIP flap, is also a useful flap for reconstruction of soft tissue defect. [5][6][7] Theoretically, SIEA flap's region is innervated by the T12 nerve and the iliohypogastric nerve (IHN), but no sensate SIEA flap has been reported so far. 8 In this case report, we present a case in which a sensate SIEA flap innervated by the IHN was used for reconstruction of a finger soft tissue defect.…”