SCIV-only versus VCs-only conduit: Which is optimal for multipaddle and chimeric SCIAP flaps?

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Vascular Surgery

Background:

• Superficial circumflex iliac vein (SCIV) and venae comitantes (VCs) are suitable for traditional superficial circumflex iliac artery perforator (SCIAP) flaps.
• Optimal venous conduit strategies for extended multipaddle and chimeric SCIAP flaps are not well-established.

Purpose of the Study:

• To investigate the efficacy of SCIV-only versus VCs-only conduits for multipaddle and chimeric SCIAP flaps.
• To compare outcomes, complication rates, operative times, and healing durations between the two conduit groups.

Main Methods:

• Retrospective study of 195 patients undergoing multipaddle or chimeric SCIAP flaps (August 2015 - July 2023).
• Analysis of flap variations (2, 3, 4-paddle, cutaneous-iliac, cutaneous-sartorius) and conduit utilization (SCIV-only vs. VCs-only).
• Comparison of primary outcomes including complication rates, operation duration, and wound healing time.

Main Results:

• VCs-only drainage was used in 85.6% of cases, while SCIV-only was used in 14.4%.
• SCIV-only flaps were predominantly 2-paddle (89.3%).
• VCs-only drainage showed increasing utilization with flap complexity: 63.2% for 2-paddle, 92.7% for 3-paddle, and 100% for 4-paddle and chimeric flaps.

Conclusions:

• VCs-only drainage is highly effective for complex SCIAP flaps, including multipaddle and chimeric types.
• This approach demonstrates superior drainage capacity for both suprafascial and subfascial tissues in extended SCIAP flaps.
• The findings support the routine use of VCs-only conduits for advanced SCIAP flap reconstructions.