Outcome of Supraclavicular Artery Island Flap for Reconstruction of Head and Neck Defects in Indian Population and Their Correlation with Flap Dimensions

This is a study to assess versatility of the supraclavicular artery island flap (SCAIF) for reconstruction of head and neck defects. This study has also evaluated complications of SCAIF and their correlation with flap dimensions.

This is a prospective study done at a single institute for 1-year duration. A total of 30 patients with head and neck cancer were included in the study. SCAIF was used in all patients for reconstruction of defect after carcinoma resection. Postoperative follow-up was done for 3 weeks. The study variables were location of defect, length and width of flap, time taken for flap harvest, and complications.

Flap-related early complications were observed in 6 (20%) patients. These early complications were distal margin necrosis in four patients, partial flap loss in one patient, and wound infection and development of orocutaneous fistula in one patient. Stiffness in neck and shoulder movements (late complication) was noted in two patients. Among patients who developed complications, the mean flap length was 16.38 cm when compared with 15.68 cm among those who did not develop complications. Difference in mean flap length was found to be statistically significant ( p -value = 0.019).

SCAIF provides a skin paddle which is hairless, thin, pliable, and color-matched with the recipient site in the head and neck region. However, its limited reach and smaller volume should be kept in mind while planning reconstruction. The safe length of SCAIF is 16 to 17 cm (up to lower third of deltoid muscle), which makes it a suitable choice for defect of lower third of the head and neck region.