Supraclavicular artery island flap in the reconstruction of oral cavity cancer defects

Abstract

Background: Microvascular free flaps are the standard of care in the reconstruction of head and neck resection defects, however they need a significant surgical expertise and increase the operative time. Supraclavicular artery island flap (SCAIF) is a versatile fasciocutaneous flap that offers the advantage of both, a regional flap (easy to harvest) and a free flap (thin and pliable) in the head and neck reconstruction.Methods: In this study we analysed the utility of this flap for the oral cavity cancer defect reconstruction done in 12 consecutive cases.Results: There were 8 males and 4 females with a mean age of 54.75 years. The oral cavity subsites were as follows: buccal 3 (25%); tongue 3 (25%); lower alveolus 2 (16.66%); floor of mouth 1 (8.33%); gingivobuccal sulcus 2 (16.66%); retromolar trigone 01(8.33%).The excisional defect size ranged from 4×2 cm to 6×3 cm with a mean size of 5×3 cm. The mean harvest time was 45 minutes (range 35 min - 65 min). We had complete flap loss in 2 (16.66%) patients and partial flap loss in 1 (8.33%) patient. Donor site wound gape was noted in 2 (16.66%) patients. The hospital stay ranged from 7 days to 10 days in non-complicated cases. The mean follow up period was of 8.58 months.Conclusions: SCAIF is versatile, easy to harvest, safe and reliable in selective cases of oral cavity cancers and a potential alternative regional flap in head and neck reconstruction.

Submandibular gland flap in reconstruction of head and neck cancer defects

“…All the patients were followed up for a minimum of 7 months and 10 cases showed successful flap uptake (91.01%), which is well in accordance with several studies on the following-up period. 26,27 The distal necrosis or wound dehiscence of the flap occurred only in one patient of buccal mucosa defects involving the RMT region with history of diabetes, alcohol consumption, and smoking, which had been well noticed in the other studies. 28,29 Although the vascularity of the flap may be affected by prior radiation, in our study one patient (9.09%) had wound dehiscence and wound gap in early postoperative periods, which responded well to conservative therapy and healed spontaneously.…”

“…24,25 Mean harvesting time for raising the flap was less than 30 minutes since it was performed as a part of neck dissection compared to the supraclavicular artery island flap (45 minutes) in oral cavity carcinoma. 26 For oral cavity defect reconstruction we recommend passing the flap pedicle through the floor of the mouth to prevent tension and shearing of the pedicle. All the patients were followed up for a minimum of 7 months and 10 cases showed successful flap uptake (91.01%), which is well in accordance with several studies on the following-up period.…”

Effect of Different Repair and Reconstruction Methods Combined with Psychological Intervention on Quality of Life and Negative Emotion in Patients with Oral Cancer

“…Computational and Mathematical Methods in Medicine patients still have serious depression tendency and even extreme behaviors such as suicide in case of complications including incision infection. Therefore, it is necessary to intervene in psychological intervention measures to reduce the possibility of medical malignant events through scientific and efficient nursing means [20][21][22][23].…”