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Lymphatic Patterns in the Superficial Circumflex Iliac Artery Perforator Flap
José Luis Campos1, Sinikka Suominen2, Gemma Pons3
1Department of Microsurgery, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain.
Journal of Reconstructive Microsurgery
|June 7, 2024
Summary
Superficial circumflex iliac artery perforator (SCIP) flaps show predominantly linear lymphatic patterns directed toward the inguinal lymph node. Understanding these lymphatic pathways is crucial for effective lymphedema surgery.
Area of Science:
- Microsurgery
- Vascular Surgery
- Lymphedema Research
Background:
- Lymphedema results from lymphatic system impairment, causing chronic fluid buildup and swelling.
- Lymph interpositional flap transfer restores lymph flow using flaps with subdermal lymphatic channels.
- The superficial circumflex iliac artery perforator (SCIP) flap is a viable option for this reconstructive technique.
Purpose of the Study:
- To describe and characterize the lymphatic drainage patterns within the vascular territory of the SCIP flap.
- To evaluate the feasibility of using SCIP flaps for lymphedema surgery.
Main Methods:
- A cross-sectional, multicenter study involving 19 healthy adult volunteers.
- Indocyanine green (ICG) lymphography assessed superficial lymphatic patterns in the SCIP flap zone at 4, 14, and 24 minutes.
- Standardized procedures were used across all participants and hospitals.
Main Results:
- A predominantly linear lymphatic pattern was observed bilaterally in the SCIP flap zone.
- The number and length of lymphatic vessels increased over time post-injection.
- Most lymphatic vessels drained towards the inguinal lymph node (ILN), with some exceptions noted on the left side.
Conclusions:
- SCIP flap lymphatic patterns are generally consistent bilaterally, primarily draining towards the ILN.
- Understanding lymphatic axiality and patterns is essential before using SCIP flaps for effective lymphedema treatment.
- These findings support the SCIP flap's potential for lymphatic reconstruction in lymphedema management.
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