Clinical application of supraclavicular flap for head and neck reconstruction

To assess the efficacy and clinical application of a supraclavicular flap for head and neck reconstruction.

A pedicled supraclavicular flap was used on 26 patients at Sun Yat-Sen University Cancer Center between July 2017 and November 2018, including 16 cases with oral cancer defects, 7 cases with laryngeal cancer and hypopharyngeal carcinoma defects, 1 case with parotid gland cancer defects, 1 case with external auditory canal cancer defects, and 1 case with tracheal esophageal fistula. The time required to harvest the flap, the amount of intraoperative blood loss, the duration of postoperative drainage tube placement, the outcome of the flap, and the healing observed at the donor site are reported.

The sizes of the flaps were 6-20 × 4-6.5 cm. The time required to harvest the supraclavicular flap ranged from 25 to 35 min and averaged 30 min. The amount of intraoperative blood loss ranged from 20 to 100 ml and averaged 58.8 ml. The duration of postoperative drainage tube placement ranged from 3 to 8 days and averaged 5.9 days. A total of 23 flaps survived. In two cases, the distal blood supply of the flaps was poor, but the flaps survived after debridement and suturing. One flap had partial necrosis, but survived after conservative treatment. All donor area defects were directly sewed and stitched without complications.

There are multiple advantages of the supraclavicular flap, including simple preparation technique, reliable repair of the defects, and without the need for performing microvascular anastomosis. It can be safely used in head and neck reconstruction after surgery.