Fernandez-Garrido Manuel, Nunez-Villaveiran Teresa, Zamora Paul, Masia Jaume, Leon Xavier
Plastic and Reconstructive Surgery Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Plastic and Reconstructive Surgery Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
J Plast Reconstr Aesthet Surg. 2022 Sep;75(9):3217-3225. doi: 10.1016/j.bjps.2022.06.021. Epub 2022 Jun 23.
We describe a variation of the superficial circumflex inguinal artery perforator (SCIP) flap, based the superficial branch of the superficial circumflex inguinal artery (SCIA) METHODS: The vascular supply of the SCIP flap was prospectively studied in 91 preoperative CT angiograms in patients undergoing reconstruction with other flaps, and verified randomly with a hand-held doppler in 20% of them. Based on the results, a new SCIP flap was designed medial and cranial to the anterosuperior iliac spine (ASIS) using the superficial branch of the SCIA. This flap was used in 39 patients to reconstruct lower limb and head and neck defects RESULTS: The superficial branch of the SCIA was found in all patients and its exit point through Hesselbach's fascia was located within a 21 mm-radius circumference drawn 18 mm medial and 17 mm distal to the ASIS in 90% of the patients. Reconstruction with this SCIP flap was successful in 92.3% of the patients. Complications were present in 17.9% of the patients CONCLUSIONS: The design of the SCIP flap can be displaced cranially to obtain a larger flap with a long and constant vascular pedicle that is based on the main trunk of the SCIA. This facilitates the reconstruction of large and complex three-dimensional defects that require thin and pliable tissue, such as those located in the head and neck or limbs. Furthermore, supramicrosurgical expertise is not required.
IV.
我们描述了一种基于腹股沟浅动脉（SCIA）浅支的腹股沟浅动脉穿支（SCIP）皮瓣的变异术式。方法：前瞻性研究了91例接受其他皮瓣重建患者的术前CT血管造影中SCIP皮瓣的血供情况，并随机选取其中20%的患者用手持多普勒进行验证。基于研究结果，利用SCIA浅支在髂前上棘（ASIS）内侧和头侧设计了一种新的SCIP皮瓣。该皮瓣应用于39例患者，用于重建下肢及头颈部缺损。结果：所有患者均发现了SCIA浅支，90%的患者中其穿出海氏筋膜的点位于以ASIS内侧18 mm、远侧17 mm为圆心、半径21 mm的圆周内。该SCIP皮瓣重建手术在92.3%的患者中成功。17.9%的患者出现了并发症。结论：SCIP皮瓣的设计可向头侧移位，以获得一个具有长且恒定血管蒂的更大皮瓣，该血管蒂基于SCIA主干。这便于重建需要薄而柔韧组织的大型复杂三维缺损，如头颈部或四肢的缺损。此外，不需要超显微外科技术。证据级别：IV级。
