Iida Takuya, Mihara Makoto, Yoshimatsu Hidehiko, Narushima Mitsunaga, Koshima Isao
From the Department of Plastic and Reconstructive Surgery, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
Ann Plast Surg. 2014 Mar;72(3):332-6. doi: 10.1097/SAP.0b013e318260a3ad.
The superficial circumflex iliac artery perforator (SCIP) flap was first reported in 2004, in which the concept of perforator flap was incorporated into the groin flap. Although a SCIP flap has many advantages, reports on its application to head and neck defects are limited. We present cases of SCIP flap transfer for reconstruction of various types of head and neck defects.Twelve patients underwent reconstruction using the free SCIP flap after tumor ablative surgery in the head and neck region. The flap was elevated based on the perforators of the superficial branch and/or deep branch of the superficial circumflex iliac artery. The thickness of the flap was adjusted according to the defect. The Photo Dynamic Eye infrared camera system using indocyanine green was used to detect the location of the perforators preoperatively and to confirm the blood flow after elevation of the flap. The flaps survived completely in all the cases. The mean pedicle length was 7.1 cm (range, 6-9 cm), and the mean flap size was 12.8 × 6.3 cm (range, 4 × 2 to 18 × 8 cm). No vein grafting was necessary in any patient.The advantages of the SCIP flap include 1) low donor-site morbidity; the donor site is in a hairless concealed area, primary donor-site closure is possible, and no muscular dissection is necessary; 2) adjustable thickness of the flap from a superthin flap to a bulky flap; and 3) a long vascular pedicle available.We believe that the SCIP flap will become one of the most versatile options in head and neck reconstruction.
旋髂浅动脉穿支（SCIP）皮瓣于2004年首次被报道，它将穿支皮瓣的概念融入腹股沟皮瓣。尽管SCIP皮瓣有许多优点，但关于其应用于头颈部缺损的报道有限。我们展示了应用SCIP皮瓣转移修复各种类型头颈部缺损的病例。12例患者在头颈部肿瘤切除术后采用游离SCIP皮瓣进行修复。皮瓣基于旋髂浅动脉浅支和/或深支的穿支掀起。根据缺损情况调整皮瓣厚度。使用吲哚菁绿的光动力眼红外摄像系统在术前检测穿支位置，并在皮瓣掀起后确认血流情况。所有病例皮瓣均完全存活。平均蒂长为7.1 cm（范围6 - 9 cm），平均皮瓣大小为12.8×6.3 cm（范围4×2至18×8 cm）。所有患者均无需静脉移植。SCIP皮瓣的优点包括：1）供区并发症少；供区位于无毛隐蔽区域，供区可一期闭合，无需进行肌肉分离；2）皮瓣厚度可从超薄皮瓣调整为厚皮瓣；3）有较长的血管蒂。我们认为SCIP皮瓣将成为头颈部重建中最通用的选择之一。
