González-García José A, Chiesa-Estomba Carlos M, Sistiaga Jon A, Larruscain Ekhiñe, Álvarez Leire, Altuna Xabier
Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello, Hospital Universitario Donostia-Donostia Unibersitate Ospitalea, Donostia-San Sebastián, Gipuzkoa, España.
Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello, Hospital Universitario Donostia-Donostia Unibersitate Ospitalea, Donostia-San Sebastián, Gipuzkoa, España.
Acta Otorrinolaringol Esp (Engl Ed). 2018 Jan-Feb;69(1):8-17. doi: 10.1016/j.otorri.2017.03.004. Epub 2017 May 13.
The supraclavicular island flap is a rotational pedicled flap and may have some advantages in head and neck reconstruction compared with free-tissue transfer when this kind of reconstruction is not affordable or recommended.
We present our experience during the year 2016 in the application of the supraclavicular island flap in five cases as an alternative to microvascular reconstruction in several defects after resection of head and neck tumours. In two patients, the flap was used to close the surgical pharyngostoma after total laryngectomy with partial pharyngectomy. In one patient, it was used in lateral facial reconstruction after partial resection of the temporal bone. In one case, it was used to close a skin defect after total laryngectomy with prelaryngeal tissue extension. And in the last case to close a neck skin defect after primary closure of a pharyngo-cutaneous fistula. There were no flap complications, and the result was satisfactory in all cases.
The supraclavicular artery island flap is useful and versatile in head and neck reconstruction. Operating room time in aged patients or those with comorbidities will be reduced compared to free flaps. The surgical technique is relatively easy and can be used for skin and mucosal coverage.
The supraclavicular island flap could be a recommended option in head and neck reconstruction, its use seems to be increasing and provides a safe and time-saving option to free flaps in selected patients.
锁骨上岛状皮瓣是一种带蒂旋转皮瓣，在头颈部重建中，当无法负担或不推荐进行游离组织移植时，它可能具有一些优势。
我们介绍了2016年应用锁骨上岛状皮瓣的经验，共5例，作为头颈部肿瘤切除后多种缺损微血管重建的替代方法。2例患者中，该皮瓣用于全喉切除并部分咽切除术后关闭手术性咽瘘。1例患者，用于颞骨部分切除术后的面部外侧重建。1例中，用于全喉切除并喉前组织扩展术后关闭皮肤缺损。最后1例用于咽皮肤瘘一期闭合后关闭颈部皮肤缺损。未出现皮瓣并发症，所有病例结果均满意。
锁骨上动脉岛状皮瓣在头颈部重建中实用且用途广泛。与游离皮瓣相比，老年患者或有合并症患者的手术室时间会减少。手术技术相对简单，可用于皮肤和黏膜覆盖。
锁骨上岛状皮瓣可能是头颈部重建中一种推荐选择；其应用似乎在增加，为特定患者提供了一种安全且节省时间的游离皮瓣替代方案。
