Supraclavicular fasciocutaneous flap for head and neck reconstructive surgery

Abstract

The purpose of the work is to present modern data on the plastic closure of head and neck defects after malignant tumors removing and in burn injury of this region using supraclavicular flap in the professional literature. This article presents the review and comparison results of modern researches on topographical features of transverse cervical artery and supraclavicular artery, as well as these vessels peak blood flow velocity for the purpose of optimal blood supply preservation in the surgically formed supraclavicular artery flaps. The review describes the study results of topographical features of the cutaneous cervical plexus nerves, consideration of which makes it possible to save or not to save the skin sensibility of flap depending on the surgeon’s goal. The review addresses the analysis results of complications following postoperative defects of soft tissue, skin and mucous membranes surgical closure after head and neck malignant neoplasms removal with a detailed description of the complications nature, localization and size of defects, relation to previous radiotherapy. Our own experience results of reconstruction with supraclavicular flap for head and neck oncosurgery in 77 patients are also presented. The review provides the results of comparative studies on perforating supraclavicular fasciocutaneous flap as well as the microvascular forearm free flap use, with the analysis of total operative time and duration of flap division, the need to stay in an intensive care unit, postoperative morbidity, long-term functional results and the total cost of treatment. There are the results of the supraclavicular flap use in head and neck burn wounds closure with the analysis of complications and long-term functional and cosmetic outcomes. Based on the large clinical experience (a total of 316 patients) obtained in 12 clinics over a period of more than 10 years, it can be concluded that the supraclavicular fasciocutaneous flap has a number of advantages and is recommended for widespread use in the plastic closure of head and neck defects after burn injury and malignant tumors

Keywords

• supraclavicular artery
• surgical flaps
• head and neck neoplasms
• soft tissue injuries