Study of the Medial Superficial Perforator of the Superficial Circumflex Iliac Artery Perforator Flap Using Computed Tomographic Angiography and Surgical Anatomy in 142 Patients

Suh, Hyun Suk; Jeong, Hyung Hwa; Choi, Donghoon; Hong, Joon Pio

doi:10.1097/prs.0000000000003147

Cited by 70 publications

(85 citation statements)

References 18 publications

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“…When a long and large skin paddle is required, it is safe to incorporate perforators from the deep branch of the SCIA, which often gives off branches running in the axial direction. This is in accordance with a report by Suh et al, which introduced two types of perforators branching off from the superficial branch of the SCIA: the direct anchoring type and the axial type, the latter enabling longer skin paddles (Suh, Jeong, Choi, & Hong, ). Thus, when employing a chimeric SCIP flap or a large SCIP flap, the deep branch of the SCIA has to be identified and dissected.…”

Section: Discussionsupporting

confidence: 92%

Use of the transverse branch of the superficial circumflex iliac artery as a landmark facilitating identification and dissection of the deep branch of the superficial circumflex iliac artery for free flap pedicle: Anatomical study and clinical applications

et al. 2019

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Background The deep branch of the superficial circumflex iliac artery (SCIA) should be included when a large superficial circumflex iliac artery perforator (SCIP) flap is necessary, or when anatomical structures perfused by the deep branch are procured. The aim of this study was first to describe the anatomical features of the “transverse branch” of the deep branch of the SCIA in cadavers, and then to assess the efficacy of its use as a landmark for identification and dissection of the deep branch of the SCIA through clinical applications. Methods Twenty groin regions from 10 cadavers were dissected. The course and the takeoff point of the transverse branch were documented. With the transverse branch used as a landmark for pedicle dissection, 27 patients (16 males and 11 females) with an average age of 51.7 years underwent reconstructions that used vascularized structures nourished by the deep branch of the SCIA. Aside from the skin paddle, an iliac bone flap was used in 10 cases, a lateral femoral cutaneous nerve flap in four cases, and a sartorius muscle flap in three cases. The defect locations included the head (seven cases), the foot (six cases), the hand (six cases), the arm (five cases), and the leg (three cases). The causes of reconstruction were tumors in 13 patients, trauma in six patients, infection in four patients, surgical procedures in three patients, and refractory ulcer in one patient. Results In all specimens, the transverse branch was found underneath the deep fascia caudal to the anterior superior iliac spine (ASIS). The average distance from the ASIS to the transverse branch was 25.5 ± 13.0 mm (range, 5–50 mm). The average dimension of the flap was 13.1 × 5.9 cm2. All the flaps survived completely after the surgery; lymphorrhea was seen in one patient at the donor site. The average follow‐up period was 12.9 months (range, from 2 to 42 months), and all patients had good functional recovery with satisfactory esthetic results. Conclusions The transverse branch was found in all specimens, branching from the deep branch of the SCIA. Successful results were achieved by using it as the landmark for identification and dissection of the deep branch of the SCIA. This method allows safe elevation of a large SCIP flap or a chimeric SCIP flap.

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Section: Discussionsupporting

confidence: 92%

Use of the transverse branch of the superficial circumflex iliac artery as a landmark facilitating identification and dissection of the deep branch of the superficial circumflex iliac artery for free flap pedicle: Anatomical study and clinical applications

et al. 2019

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“…Compared to the above‐mentioned techniques, the SCIP propeller flap allows for a relatively easy and rapid tissue transfer, as the perforator location is consistent (Suh et al, ); it is also located close to the defect site. It is simple to obtain a thin flap (Choi et al, ) and is advantageous for penoscrotal contouring because groin tissue itself is thinner than other areas.…”

Section: Discussionmentioning

confidence: 99%

“…When elevating the SCIP propeller flap based on the medial perforator, some factors need to be taken under consideration. The SCIP pedicle can be divided into axial or anchoring types (Suh et al, ). The axial type is more reliable when designing long flaps because the main pedicle usually extends beyond the ASIS.…”

Section: Discussionmentioning

confidence: 99%

“…The axial type is more reliable when designing long flaps because the main pedicle usually extends beyond the ASIS. However, because the anchoring type never passes beyond the ASIS, and, therefore, does not travel far enough, it tends to develop partial necrosis (Suh et al, ). According to our review, partial necrosis occurred in one direct‐anchoring type case and in one axial‐type case.…”

Section: Discussionmentioning

confidence: 99%

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Penoscrotal reconstruction with superficial circumflex iliac artery perforator propeller flap

2019

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Background Successful penoscrotal reconstruction requires proper resurfacing of the defect and maintenance of the original shape of the penis and scrotum. We examined the feasibility of using the superficial circumflex iliac artery perforator (SCIP) propeller flap to effectively reconstruct penoscrotal defects. Methods Eleven male patients with an average age of 62.2 years were retrospectively evaluated. The average defect size was 21.3 × 10.5 cm2 (range: 10 × 8–24 × 16 cm2). An eccentrically located elliptical flap was constructed using a handheld Doppler device after detecting the perforator as the pivot point. The medial branch of the superficial circumflex iliac artery was used for all cases. Flaps were designed to cover 70–80% of the defect area and the average rotation arc was 165°. Results The average flap dimension was 19.7 × 7.7 cm2. Two cases showed partial necrosis in the flap tip area. There were no instances of total flap loss or lymphorrhea, or complications such as scar contracture, urination problems, erectile dysfunction, or discomfort during intercourse. Conclusions The SCIP flap is an effective and ideal method for penoscrotal reconstruction considering the loose, elastic, and thin nature of the tissue. Elevation is easily facilitated, and the thickness of the SCIP flap can be adjusted without microsurgery.

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“…On the other hand, the epidermis is CK19negative. 3 Although a specific chemotherapy regimen has not been established for EMPD with distant metastases, Yoshino et al 4 studied metastatic EMPD treated with monthly docetaxel and reported that the disease control rate was as high as 83%. It is expected that docetaxel therapy will become the first-line chemotherapy for metastatic EMPD in the future.…”

mentioning

confidence: 99%

Aesthetic reconstruction of extensive pubic keloids using bilateral modified keystone flaps

Park

2018

The Journal of Dermatology

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Study of the Medial Superficial Perforator of the Superficial Circumflex Iliac Artery Perforator Flap Using Computed Tomographic Angiography and Surgical Anatomy in 142 Patients

Cited by 70 publications

References 18 publications

Use of the transverse branch of the superficial circumflex iliac artery as a landmark facilitating identification and dissection of the deep branch of the superficial circumflex iliac artery for free flap pedicle: Anatomical study and clinical applications

Use of the transverse branch of the superficial circumflex iliac artery as a landmark facilitating identification and dissection of the deep branch of the superficial circumflex iliac artery for free flap pedicle: Anatomical study and clinical applications

Penoscrotal reconstruction with superficial circumflex iliac artery perforator propeller flap

Aesthetic reconstruction of extensive pubic keloids using bilateral modified keystone flaps

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