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Local Anesthesia in Superficial Circumflex Iliac Artery Free Flap Transfer
Wai-Nang Chao1, Ka-Man Kuok2, Chi-Jui Chen3
1From the Department of Plastic, Reconstructive, and Hand Surgery.
Annals of Plastic Surgery
|January 23, 2026
Summary
Local anesthesia (LA) is a safe and effective alternative to general anesthesia for superficial circumflex iliac artery (SCIA) free flap transfers. This approach achieved 100% flap survival with minimal complications in reconstructive surgery.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Anesthesiology
Background:
- Superficial circumflex iliac artery (SCIA) free flaps are versatile for extremity, head, and neck reconstruction.
- These flaps typically use general anesthesia (GA), which carries perioperative risks.
- Local anesthesia (LA) offers a potential alternative to GA for SCIA free flap procedures.
Purpose of the Study:
- To evaluate the safety and efficacy of using only local anesthesia (LA) for SCIA free flap transfers.
- To assess flap survival rates, complications, and patient outcomes in LA-based SCIA free flap reconstructions.
Main Methods:
- Retrospective review of 27 patients undergoing SCIA free flap transfer under LA.
- LA solution composed of bupivacaine, lidocaine, sodium bicarbonate, and lactated Ringer's solution.
- Data collected included operative time, pain scores, flap survival, and complications.
Main Results:
- 100% flap survival (27/27 flaps) observed during a mean follow-up of 15.26 months.
- Mean operative time was 4.19 hours with a mean intraoperative pain score of 2.44.
- Minor complication of mildly bulky flaps in 4 cases.
Conclusions:
- Local anesthesia (LA) is a safe and effective method for SCIA free flap transfers.
- Excellent flap survival and minimal complications were achieved using LA.
- LA is a viable option for select patients undergoing SCIA free flap reconstruction.
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