Facial and Neck Reconstruction with an easy, fast and less morbid tool: Supraclavicular Artery Island Flap.

The supraclavicular artery flap was described by Pallua for use in reconstruction in cases of cervical contracture in 1997 (1). Subsequently, DiBeneddeto and collaborators demonstrated the use of this flap in the reconstruction of facial and chest wall defects (2,3). Its use for neck and face reconstruction is because the color and texture of its skin matches with the color and texture of the skin of the receiving areas of the head and neck. (1) The arterial supply of this flap is given by the supraclavicular artery. An anatomical dissection study (n=55) reports that this artery has a length of 1-7 cm and a diameter of 1.1-1.5 mm. (4) CASE REPORT: This is a 66-year-old male patient, with the presence of a melanoma tumor in the right preauricular region, which measures 10x7x8cm. At surgery, the head and neck surgery team did the resection of the tumor including the right preauricular region, and lower middle right region of the neck. For the reconstruction an ipsilateral supraclavicular artery flap was performed whose dimensions were 20 cm long and 7 cm wide, which after its transposition it was possible to cover the entire defect without complications and in the same surgical time. 6 weeks later the patient received adjuvant radiotherapy without complications related to the flap or wounds. DISCUSSION: Advances in knowledge of the physiology and anatomy of skin vascularivascularity have allowed important advances in techniques and refinements for dissecting and elevating flaps, making previously neglected flaps more reliable and applicable. (5) The supraclavicular skin island flap was used to recover the skin coverage and the volume defect resulting from the resection of an advanced malignant tumor located on the face without using a free flap for reconstruction. The supraclavicular artery flap is a good tool to treat defects in the lower portion of the face. (5) CONCLUSION: The supraclavicular flap should be considered as a workhorse in reconstructive surgery of the face because it offers significant advantages in terms of easier surgical technique, shorter operating time, and lower cost for the patient compared to a microsurgical free flap procedure, and offers similar results, versatility and less morbidity. References: -1.Zenn M. R. Flaps and Reconstructive Surgery En: Supraclavicular Artery Flap. Vol I. 2nd Ed. Ed Elsevier, Edinburgo, Londres, New York York, Oxford,
Filadelfia, San Luis, Sidney, Toronto, 2017. Ph 387-391. -2.DiBenedetto G, Auinati A, Pierangeli M, Scalise A,Bertani A. From the "charretera" to the supraclavicular fascial island flap: Revisitation and further evolution of a controversial flap. Plast Reconstr Surg. 2005;115:70–76. -3. DiBenedetto G et al.
Supraclavicular island fascial flap in the treatment of progressive hemifacial atrophy. Plast Reconstr
Surg.2008;121: 247–250.DOI: 10.1097/PRS.0b013e31816fdde8. -4. Abe M et al. Supraclavicular artery in Japanese: An anatomical basis for the flap using a pedicle containing a cervical, non perforating cutaneous branch of the superficial cervical artery. Okajimas Polia Anat Jpn. 2000;77:149–154.DOI:
10.2535/ofaj1936.77.5_149. -5 Topalan M et al. Hemifacial Resurfacing wiwith Prefabricated Induced Expanded Supraclavicular Skin Flap. Plast. Reconstr. Surg. 125: 1429, 2010. DOI:
10.1097/PRS.0b013e3181d4fda5.

Craniomaxillofacial/Head and Neck

PSTM 2024