The Supraclavicular Flap-Indications, Execution and Outcomes in Head and Neck Reconstruction

Area of Science:

• Plastic Surgery
• Head and Neck Surgery
• Reconstructive Surgery

Background:

• The supraclavicular flap (SCF) is a recognized reconstructive technique for head and neck defects.
• It merges fasciocutaneous flap pliability with locoregional reconstruction benefits.
• Its characteristics support broad applicability in head and neck region reconstruction.

Purpose of the Study:

• To review the anatomy and surgical execution of the supraclavicular flap.
• To emphasize pre- and intra-operative decision-making for improved success.
• To illustrate the flap's application through a case series.

Main Methods:

• Retrospective case series of 18 patients.
• Analysis of supraclavicular flap utilization in primary and salvage head and neck reconstruction.
• Review of indications, including skin/soft tissue resurfacing, comorbid patients, and salvage surgery.

Main Results:

• Supraclavicular flap used for skin/soft tissue resurfacing (9 patients), comorbid patients ineligible for free flaps (7 patients), and salvage surgery (2 patients).
• Three flap-related complications occurred: two minor dehiscences and one flap tip necrosis.
• Complications were managed with debridement, re-insetting, and skin grafting, allowing radiotherapy commencement.

Conclusions:

• The supraclavicular flap is a dependable choice for locoregional head and neck reconstruction.
• It offers advantages over traditional flaps like the pectoralis major flap.
• Provides superior functional and aesthetic outcomes with good skin color, pliability, and contour.