The Supraclavicular Artery Island Flap in Head and Neck Reconstruction

Kokot, Niels; Mazhar, Kashif; Reder, Lindsay; Peng, Grace Lee; Sinha, Uttam K.

doi:10.1001/jamaoto.2013.5057

Cited by 106 publications

(103 citation statements)

References 26 publications

(66 reference statements)

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“…Survey response bias and publication bias may be responsible for this discrepancy. Indeed, the handful of studies reporting higher complications, including partial and total flap necrosis rates greater than 20%, may be more representative . Further investigation of these findings is warranted.…”

Section: Discussionmentioning

confidence: 96%

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Supraclavicular flap practice patterns and outcomes: A survey of 221 AHNS surgeons

et al. 2018

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Objectives To describe American Head and Neck Society (AHNS) surgeon supraclavicular flap (SCF) practice patterns and to identify variables associated with SCF complications. Methods The design is a cross‐sectional study. An online survey was distributed to 782 AHNS surgeons between November 11, 2016, and December 31, 2016. The primary outcome was frequency of SCF complications. Independent variables included demographics, training, practice patterns, and SCF techniques. Results Adequate survey responses were obtained from 221 AHNS surgeons. Among these, 54.3% (n = 120) performed supraclavicular flaps (SCFs). Most surgeons used the SCF for cutaneous (n = 85; 78.7%) or parotid–temporal bone (n = 59; 54.6%) defects. Nearly one‐third (n = 31; 29.8%) of surgeons experienced more than a “few” SCF complications. Surgeons experienced fewer pectoralis major flap (P < 0.001) and radial forearm free flap (P < 0.001) complications compared to SCF complications. Univariate analysis demonstrated no association between surgeons with “few” SCF complications and Doppler use in SCF design (P = 0.90), harvest location (P = 0.51), and pedicle skeletonization (P = 0.25). Multivariable logistic regression revealed that surgeons performing more than 30 SCFs compared to less than or equal to 30 SCFs had a greater odds of having “few” SCF complications (odds ratio 7.1, 95% confidence interval [1.1–43.9], P = 0.04). Conclusion A majority of surgeons performing SCFs use the flap to reconstruct cutaneous and parotid–temporal bone defects. The significance of relatively higher SCF complications compared to other routine flaps should be explored further. Surgeon experience with the SCF appears to be significantly associated with SCF success, whereas training characteristics, practice patterns, and technical variations may not be associated with SCF outcomes. Level of Evidence NA Laryngoscope, 129:2012–2019, 2019

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Section: Discussionmentioning

confidence: 96%

“…A systematic review by Nthumba et al described excellent cumulative outcomes with low rates of partial necrosis (5.1%) and total necrosis (1.7%) in the 349 included patients . However, a minority of studies have described a higher incidence of complications, including a 22% to 40% incidence of partial or total flap necrosis …”

Section: Introductionmentioning

confidence: 99%

Supraclavicular flap practice patterns and outcomes: A survey of 221 AHNS surgeons

et al. 2018

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“…Reported donor site complications with the supraclavicular artery island flap are minor wound dehiscence, tightness in the shoulder, minimal widening of the donor site scar. 19 Literature reveals reports of referred sensation to the shoulder when drinking hot or cold beverages, when used for pharyngeal reconstruction. 16 This has been attributed to the middle supraclavicular nerve, probably making it a sensate flap.…”

Section: Discussionmentioning

confidence: 99%

Supraclavicular Artery Flap – A promising versatile Flap: An early Experience

Thomas¹,

Janardhan²,

Krishnan³

et al. 2016

International Journal of Head and Neck Surgery

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Introduction: Reconstruction of major head and neck defects remains challenging for head and neck surgeons . As esthetic expectations are extremely demanding, in terms of colormatch, texture and functional dexterity. Reconstructive options range widely from skin grafts tolocoregional or even free flaps. The need of the hour would be a versatile flap that harbours only the desired characteristics of both local and free flaps.

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“…Additionally, free flap surgery requires specialized expertise that may not be readily available in all centers. Furthermore, this technique is associated with longer operative times and more extensive postoperative monitoring in intensive care units (Kokot et al, 2013). Because we do not need to consult a plastic surgeon for reconstruction, this operation can be scheduled five days per week.…”

Section: Introductionmentioning

confidence: 99%

Vascular anatomy is a determining factor of successful submental flap raising: a retrospective study of 70 clinical cases

Lin

Huang

Chu

et al. 2017

PeerJ

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The vascular anatomy of submental flaps (SFs) represents a determining factor in successful SF raising. However, little attention has been focused on the venous return of SFs. Thus, the present study aimed to investigate SF venous return. This study enrolled patients who underwent SF reconstructive surgery in a tertiary referral center between November 2009 and October 2016. The drainage pathway of the SF venous return was routinely identified during the course of our operations to prevent damage during head and neck surgery. The venous return data of 70 patients were reviewed. The size of the flaps ranged from 15 to 84 cm2, and total flap loss was not observed in the case series. All of the submental arteries originated from the facial artery; however, the submental veins of 70 patients returned to either the internal jugular vein (IJV, 72.9%) or the external jugular vein (EJV, 27.1%). Our data suggest that drainage of the submental vein into the EJV, which has been previously overlooked, should receive greater attention during SF surgeries. The results support mandatory preservation of the EJV and IJV and indicate that vascular anatomy is a determining factor for successful SF raising.

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The Supraclavicular Artery Island Flap in Head and Neck Reconstruction

Cited by 106 publications

References 26 publications

Supraclavicular flap practice patterns and outcomes: A survey of 221 AHNS surgeons

Supraclavicular flap practice patterns and outcomes: A survey of 221 AHNS surgeons

Supraclavicular Artery Flap – A promising versatile Flap: An early Experience

Vascular anatomy is a determining factor of successful submental flap raising: a retrospective study of 70 clinical cases

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