Versatility of free SCIA/SIEA flaps in head and neck defects

Area of Science:

• Plastic Surgery
• Head and Neck Surgery
• Reconstructive Surgery

Background:

• Head and neck defects often necessitate reconstruction involving bony structures, soft tissues, and oral mucosa.
• Maxillary defects and other complex head and neck reconstructions frequently rely on soft tissue flaps for repair.

Observation:

• The study investigated the use of free superficial circumflex iliac artery/superficial inferior epigastric (SCIA/SIEA) flaps for head and neck reconstruction.
• Fifteen patients underwent reconstruction with 16 free SCIA/SIEA flaps, with no observed flap loss.
• Three cases required emergency vascular reanastomosis, and four patients underwent flap thinning or debulking procedures.

Findings:

• Free SCIA/SIEA flaps demonstrated versatility and were the preferred choice over other free flaps.
• Functional and aesthetic outcomes were deemed acceptable in all patients.
• Key advantages include the ability to elevate large flaps for distant vessels, simultaneous donor and recipient site preparation by two teams, and minimal donor site morbidity due to the abdominoplasty incision.

Implications:

• The free SCIA/SIEA flap is a valuable option for soft tissue defect reconstruction in the head and neck.
• Its unique advantages make it suitable for complex reconstructive challenges.
• This technique offers a balance of functional restoration and aesthetic results with manageable donor site impact.