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

The supraclavicular flap (SCF) is a well-established reconstructive option for defects of the head and neck. It combines the pliability of a fasciocutaneous flap with the benefits of locoregional reconstruction. These characteristics enable the flap to be widely applicable in the head and neck region.

The anatomy and surgical execution for the supraclavicular flap is reviewed with emphasis on the decision-making process pre- and intra-operatively to improve success along with illustration of a case series of patients.

In a retrospective case series of 18 patients in a single institution, the SCF was utilised both as primary and salvage options in head and neck reconstruction. The indications for SCF included skin and soft tissue resurfacing (n = 9), comorbid patients not eligible for free flaps (n = 7) and in salvage surgery (n = 2). We had three flap related complications requiring return to theatre to facilitate healing prior to commencement of post-operative radiotherapy. These included two cases of minor dehiscence which were re-debrided and inset; and one case of flap tip necrosis which was treated with debridement and skin grafting.

The supraclavicular flap is a reliable option for locoregional head and neck reconstruction. It also has several advantages over more traditional options such as the pectoralis major flap, providing a more functional and aesthetic result with close to ideal skin colour, pliability, and contour.