SCIV-only versus VCs-only conduit: Which is optimal for multipaddle and chimeric SCIAP flaps?

Abstract

Background

Superficial circumflex iliac vein (SCIV) and venae comitantes were qualified for traditional superficial circumflex iliac artery perforator (SCIAP) flaps. Optimal approaches for multipaddle and chimeric SCIAP flaps remain elusive. The purpose of this study is to investigate validities of SCIV-only and VCs-only conduits for such extended SCIAP flaps.

Methods

A retrospective study was conducted from August 2015 to July 2023 at the author’s institution. All patients who underwent multipaddle and chimeric SCIAP flaps with complete follow-up information were involved. The multipaddle SCIAP flaps included 2, 3, and 4-paddle variations, while the chimeric series involved cutaneous-iliac and cutaneous-sartorius SCIAP flaps. A comparison was made between the primary outcomes of the SCIV-only group and the VCs-only group in terms of the proportion of these variations and complications, as well as operation duration, and wound healing time.

Results

Of 195 patients, the VCs-only conduit accounts for 85.6% (n = 167) and the SCIV-only approach accounts for 14.4% (n = 28). In the SCIV-only group, 89.3% were performed for 2-paddle flaps. In the VCs-only group, 167 flaps were drained by this approach, including 43 (25.8%) cases of 2-paddle flaps, 38 (22.8%) cases of 3-paddle flaps, 22 (13.2%) cases of 4-paddle flaps, 36 (21.6%) cases of cutaneous-iliac flaps, and 28 (16.8%) cases of cutaneous-sartorius flaps. The utilization rate of the VCs-only conduit was 63.2% in 2-paddle flaps, 92.7% in 3-paddle flaps, and 100% in 4-paddle and chimeric SCIAP flaps.

Conclusion

This study stands in support of VCs-only drainage for multipaddle and chimeric SCIAP flaps due to its effective drainage capacity of suprafascial and subfascial tissues.