Repair of a “long and narrow” skin defect of the upper extremity with a modified design of a compound SCIP flap: a series of 12 cases

Abstract

Abstract Background Large skin lesions of the upper extremity tend to be ‘‘long and narrow’’ in shape, and the currently used repair and reconstruction protocols still have some drawbacks, including difficulty in closure of the donor area, poor cosmetic appearance of the donor and recipient areas, and low flap survival rates. The ilioinguinal flap has been more widely used for repair and reconstruction of various complex conditions. In order to improve the versatility of the flap design and to achieve better aesthetic results, we report a study on the improved design of Compound SCIP flap for repairing "long and narrow" large skin defects of the upper extremity by using a modified design of the ilioinguinal flap for the procurement of perforating blood vessels and flap excision. Methods From April 2005 to August 2015, a total of 12 patients underwent this modified design procedure, in which the anterior branch of the fourth lumbar artery or the posterior intercostal artery was selected to provide blood supply for the perforator flap together with the superficial branch of the superficial iliac artery to meet the blood supply needs of the flap for the one-time repair of a large "long and narrow" skin defect in the upper limb. Patient demographics, flap characteristics, and associated complications were retrospectively analyzed. Results 3 females and 9 males were included in this study, the mean age of the patients was 31.7 years (range, 22–44 years), the mean follow-up period was 15.3 ± 5.6 months (range, 7–24 months), and all patients had complete closure of the defect site and donor area, and all flaps survived. Conclusions The Compound SCIP flap presents some advantages in repairing 'long and narrow' skin defects in the upper limb. While ensuring the survival rate of the elongated ilioinguinal flap, it amplifies the benefits of the ilioinguinal flap and enhances skin utilization. This can serve as a beneficial choice for repairing 'long and narrow' skin defects in the upper limb.

Keywords

• Conjoined perforator flap
• Free inguinal flap
• Superficial circumflex iliac artery(SCIA)
• Posterior intercostal arteries perforator (PICAP)
• Lumbar artery perforator flaps (LAPs)
• Upper extremity reconstruction