Vinh Vu Quang, Van Anh Tran, Ogawa Rei, Hyakusoku Hiko
Hanoi, Vietnam; and Tokyo, Japan From the Department of Plastic and Reconstructive Surgery, Vietnam National Institute of Burns, and the Department of Plastic and Reconstructive Surgery, Nippon Medical School Hospital.
Plast Reconstr Surg. 2009 May;123(5):1471-1480. doi: 10.1097/PRS.0b013e3181a205ba.
The supraclavicular flap is an excellent flap that has been used widely, but its vascular reliability remains unclear. In this article, the authors report the results of their anatomical studies on 40 flaps from 20 preserved cadavers and their clinical studies of 103 supraclavicular flaps in 101 patients.
In their anatomical study, the authors analyzed the important anatomical features that are useful for harvesting flaps. In their clinical study, the authors analyzed the cases in terms of flap reliability.
The supraclavicular artery branched from the transverse cervical artery in all 40 specimens (100 percent). Although it arose from the middle third of the clavicle in 90 percent of the specimens, it arose from the lateral third of the clavicle in four specimens (10 percent). Moreover, the transverse cervical artery originated from the subclavian artery in two of 40 specimens (5 percent) rather than from the thyrocervical trunk. The origins of the supraclavicular and transverse cervical arteries were on average 4.12 cm apart (range, 3 to 5.5 cm). In our clinical study, 101 of the 103 flaps (98.1 percent) were (vascular-pedicled) island flaps and five (4.9 percent) were transferred under a skin tunnel. We also performed a supercharged flap transfer using posterior circumflex humeral vessels. Of the 103 flaps, 97 survived completely (94.2 percent), but four and two exhibited superficial distal necrosis (3.9 percent) and total necrosis (1.9 percent), respectively.
Supraclavicular flaps are reliable, but vascular anomalies exist. In the authors' experience, the posterior circumflex humeral artery could be used for supercharging the supraclavicular flap.
锁骨上皮瓣是一种应用广泛的优秀皮瓣，但其血管可靠性仍不明确。在本文中，作者报告了他们对20具保存尸体的40个皮瓣进行解剖学研究以及对101例患者的103个锁骨上皮瓣进行临床研究的结果。
在解剖学研究中，作者分析了有助于切取皮瓣的重要解剖特征。在临床研究中，作者从皮瓣可靠性方面分析了病例。
在所有40个标本（100%）中，锁骨上动脉均起自颈横动脉。虽然90%的标本中它起自锁骨中1/3，但有4个标本（10%）起自锁骨外1/3。此外，40个标本中有2个（5%）颈横动脉起自锁骨下动脉而非甲状颈干。锁骨上动脉和颈横动脉的起点平均相距4.12 cm（范围为3至5.5 cm）。在我们的临床研究中，103个皮瓣中有101个（98.1%）为（带血管蒂）岛状皮瓣，5个（4.9%）是通过皮下隧道转移的。我们还使用旋肱后血管进行了增压皮瓣转移。103个皮瓣中，97个完全存活（94.2%），但分别有4个（3.9%）和2个（1.9%）出现远端浅表坏死和完全坏死。
锁骨上皮瓣是可靠的，但存在血管变异。根据作者的经验，旋肱后动脉可用于对锁骨上皮瓣进行增压。
