Treatment of trunk defects using perforator flaps: A case series introducing suprascapular artery perforator flap

This case series explores the efficacy of freestyle perforator flaps, including the newly introduced suprascapular artery perforator flap (SSAP), in reconstructing trunk defects. Over a five-year period, 24 perforator flap procedures were performed on 19 patients, primarily for defect reconstruction after skin tumor and ulcer resections. Flap design was customized using preoperative doppler ultrasound and they were then transferred to defects in a V-Y or propeller fashion. The most frequently utilized flaps were the dorsal intercostal artery perforator (DICAP) flap and the lumbar artery perforator (LAP) flap. Notably, SSAP flaps were successfully employed for shoulder defects resulting from squamous cell carcinoma resections.

Complications occurred in 29 % of cases, including seroma evacuation, hematoma, and wound dehiscence, with one patient experiencing severe liver failure post-surgery. The versatility of perforator-based reconstruction was demonstrated through the combination of DICAP and LAP flaps for large trunk defects. Additionally, internal mammary artery perforator (IMAP) and lateral thoracic artery perforator (LTAP) flaps were utilized for parasternal and infraclavicular defects, respectively.

The introduction of the SSAP flap expands the options for dorsal shoulder area reconstruction, offering faster healing and superior cosmetic results compared to traditional methods like secondary intention healing or skin grafting. Although this study showcases promising outcomes, further research is warranted to validate the effectiveness of SSAP flaps and to explore their applications in a broader patient population.