D'Aco Luigi Filippo, Cagnoni Laura, Murè Carmelo, Piazza Alessandro, Aresi Giuseppe, Panciera Davide Thomas
Department of Otorhinolaryngology, Azienda Socio Sanitaria Territoriale (ASST) Bergamo Est, Hospital Bolognini, Seriate (BG), Italy.
Int Arch Otorhinolaryngol. 2022 Aug 1;27(1):e117-e122. doi: 10.1055/s-0042-1744169. eCollection 2023 Jan.
For a long time, major surgical defects after oncological surgery have always been challenging cases for surgeons in terms of wound healing and covering technique. To demonstrate the feasibility of supraclavicular artery flap (SCAF) in the reconstruction of surgical defects in those "fragile" patients undergoing oncological surgery who could not possibly have endured the timeframes involved in using microvascular free flaps. Between January 2018 and January 2019, at the Azienda Socio Sanitaria Territoriale (ASST) Bergamo Est Hospital (Bergamo, Italy), we reported the cases of 11 patients in whom the SCAF was used for surgical reconstruction after oncological surgery in our Otolaryngology Department. The median age of the 11 patients was 68.7 years old. The SCAF has proved, in almost all 11 cases in which it was used, to be very reliable and, above all, easy and quick to make in those "fragile" patients without the need for further intervention. There was only one case in which the resection involved the auricle entirely and a small area of perimeatal bone exposure occurred, which, anyway, healed by secondary intention. The SCAF is an extremely versatile flap for head and neck surgery to be considered especially for fragile and vulnerable patients who cannot undergo prolonged surgical time. Moreover, this technique has also shown high feasibility in small hospitals where there is not a plastic surgery department and the surgeon may face the difficulty of practicing surgical reconstruction after enlarged resection.
长期以来，肿瘤外科手术后的重大手术缺损在伤口愈合和覆盖技术方面一直是外科医生面临的具有挑战性的病例。为了证明锁骨上动脉皮瓣（SCAF）在那些无法耐受使用游离微血管皮瓣所需时间的“脆弱”肿瘤手术患者手术缺损重建中的可行性。2018年1月至2019年1月期间，在意大利贝加莫省东部社会卫生服务机构（ASST）贝加莫医院（贝加莫，意大利），我们报告了11例在我们耳鼻喉科接受肿瘤手术后使用SCAF进行手术重建的患者病例。这11例患者的中位年龄为68.7岁。在几乎所有使用SCAF的11例病例中，它已被证明非常可靠，最重要的是，在那些“脆弱”患者中制作简单快捷，无需进一步干预。只有1例切除完全涉及耳廓，出现了一小部分耳道周围骨暴露，不过，这通过二期愈合。SCAF是一种用于头颈外科的极其通用的皮瓣，尤其适用于那些无法耐受长时间手术的脆弱患者。此外，在没有整形外科且外科医生在扩大切除后可能面临手术重建困难的小医院中，该技术也显示出很高的可行性。
