Franchi Alberto, Perozzo Filippo Andrea Giovanni, Tiengo Cesare, Walber Jonas, Parisato Alice, Jandali Abdul Rahman, Jung Florian
Department of Hand and Plastic Surgery, Cantonal Hospital of Winterthur, Brauerstrasse 15, 8400 Winterthur, Switzerland.
Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital of Padua, 35128 Padova, Italy.
J Clin Med. 2025 Jan 30;14(3):921. doi: 10.3390/jcm14030921.
In reconstructive microsurgery, the aesthetic outcome has gained increasing importance, and new applications of flaps have been explored, focusing on improved donor site concealment. This paper presents our experience with flaps gaining popularity in reconstructive microsurgery, specifically the SCIP/SIEA and PAP flaps. : Since August 2022, SCIP/SIEA and PAP flaps have been offered for soft tissue reconstruction across all body regions. These flaps were added to the other traditionally offered free flaps, such as RFF, mSAP, ALT, DIEP, and LD. Where the defect could be equally reconstructed using flaps from various donor sites, the choice of donor site was left to the patient. In all other cases, the donor site was selected by the surgeon according to clinical needs. This retrospective study analyzes the first author's experience with the SCIP/SIEA and PAP flaps, providing an overview of their applications, outcomes, advantages, and disadvantages. : A total of 79 patients were reconstructed with 86 free flaps during the study period. The SCIP/SIEA flap was used in 54 patients, and the PAP flap in 18 patients. Flaps other than SCIP/SIEA were used in the remaining seven. Among the 27 patients who were given the option to choose their donor site, 8 selected either the abdomen or inner thigh (5 and 3 cases, respectively). The remaining 19 patients expressed no preference and left the choice to the surgeon. Defects involved the head and neck in 30 patients (38.0%), extremities in 25 (31.7%), the breast in 23 (29.1%), and the trunk in 1 patient (1.3%). Major complications occurred in 12 patients (15.2%) while minor complications managed conservatively occurred in 18 patients (22.8%). Four flaps (4.7% of all flaps) were lost. : In our clinical practice, the SCIP/SIEA and PAP flaps have proven reliable as workhorse flaps for small to large soft tissue defects. For very large defects, the latissimus dorsi flap remains the most reliable solution.
在重建显微外科中，美学效果变得越来越重要，人们探索了皮瓣的新应用，重点是改善供区隐蔽性。本文介绍了我们在重建显微外科中使用越来越普遍的皮瓣的经验，特别是SCIP/SIEA皮瓣和PAP皮瓣。自2022年8月以来，SCIP/SIEA皮瓣和PAP皮瓣已用于全身各部位的软组织重建。这些皮瓣被添加到其他传统提供的游离皮瓣中，如桡侧前臂游离皮瓣（RFF）、内侧股薄肌皮瓣（mSAP）、股前外侧皮瓣（ALT）、腹壁下动脉穿支皮瓣（DIEP）和背阔肌皮瓣（LD）。在可以使用各种供区皮瓣同等重建缺损的情况下，供区的选择由患者决定。在所有其他情况下，供区由外科医生根据临床需要选择。这项回顾性研究分析了第一作者使用SCIP/SIEA皮瓣和PAP皮瓣的经验，概述了它们的应用、结果、优点和缺点。在研究期间，共有79例患者接受了86例游离皮瓣重建。54例患者使用了SCIP/SIEA皮瓣，18例患者使用了PAP皮瓣。其余7例使用了SCIP/SIEA以外的皮瓣。在27例可以选择供区的患者中，8例选择了腹部或大腿内侧（分别为5例和3例）。其余19例患者没有偏好，将选择留给了外科医生。缺损累及头颈部30例（38.0%），四肢25例（31.7%），乳房23例（29.1%），躯干1例（1.3%）。12例患者发生了严重并发症（15.2%），18例患者发生了经保守处理的轻微并发症（22.8%）。4例皮瓣（占所有皮瓣的4.7%）坏死。在我们的临床实践中，SCIP/SIEA皮瓣和PAP皮瓣已被证明是用于大小不等软组织缺损的可靠主力皮瓣。对于非常大的缺损，背阔肌皮瓣仍然是最可靠的解决方案。
