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Arterializing the Venous System in a SCIP Flap-Insights Into Tissue Perfusion Biomechanics: A Case Report
Edward A Stanley1,2, Vlad Illie1
1Department of Plastic and Reconstructive Surgery, St Vincent's Hospital, Sydney, New South Wales, Australia.
Microsurgery
|July 7, 2025
Summary
This case report demonstrates arterializing a deep venous system for tissue perfusion in a superficial circumflex iliac artery perforator (SCIP) flap reconstruction. This novel technique repurposed veins for inflow, successfully supporting flap viability and offering new reconstructive surgery insights.
Area of Science:
- Plastic Surgery
- Vascular Surgery
- Reconstructive Surgery
Background:
- Superficial circumflex iliac artery perforator (SCIP) flaps are used in reconstructive surgery.
- Pedicle damage can compromise flap viability.
- Novel techniques are needed to overcome reconstructive challenges.
Observation:
- A SCIP flap was used to reconstruct a defect on the mandible.
- Due to pedicle damage, the deep venous system (venae comitantes) was arterialized using a facial artery branch for inflow.
- The superficial circumflex iliac vein served as the outflow.
- Initial venous congestion resolved spontaneously, with successful flap healing.
Findings:
- Arterialization of the deep venous system can effectively support tissue perfusion in flap reconstruction.
- The venous system can be repurposed as an inflow pathway, challenging traditional perfusion models.
- Successful flap survival was achieved despite initial venous congestion.
Implications:
- This technique offers new insights into tissue perfusion biomechanics.
- It expands the potential donor sites for flap reconstruction by utilizing venous systems.
- This approach may increase the versatility of reconstructive surgery techniques.
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