Transverse Branch-Based Superficial Circumflex Iliac Artery Perforator Flap: Expanding Indications with a Longer...

The superficial circumflex iliac artery (SCIA) perforator (SCIP) flap is being increasingly used, but little is known about use of the SCIA transverse branch (SCIAt) as a pedicle. This study aimed to elucidate the characteristics and feasibility of the SCIAt-based SCIP (SCIP-t) flap.

Medical charts of patients who underwent free SCIP-t flap transfer were reviewed. SCIP-t flaps were elevated in a freestyle manner with proximal to distal dissection; the SCIAt was dissected from the proximal SCIA deep branch (SCIAd) to the distal perforator of SCIAt penetrating the deep fascia below the anterior superior iliac spine. Another branch from the SCIAd was used for additional skin paddle if needed. Clinical and operative findings were collected to evaluate the characteristics and feasibility of the SCIP-t flap.

Fifty-seven SCIP-t flaps were transferred in 57 patients, among which 12 flaps (21.1%) had double skin paddles. The skin flap area ranged from 35 to 355 cm 2 (average, 129.0 cm 2 ). The flap pedicle length ranged from 8 to 17 cm (average, 11.9 cm). All donor sites were closed primarily without skin grafting. All flaps survived except in 2 cases (3.5%), for partial necrosis; the partial necrosis defect could be conservatively managed in both cases.

The SCIP-t flap had a longer pedicle and could be elevated with an additional skin paddle based on another branch from the SCIAd. SCIP-t flap transfer allows larger skin reconstruction and primary donor-site closure without skin grafting.