Technical Refinements of Supraclavicular Artery Island Flap With Submuscular Tunnel for Reconstruction of Remote Head and Neck Postburn Scars.

Background: The supraclavicular artery island flap (SCAIF) has been used extensively to reconstruct postburn scars in the head and neck region. Its landmark and vascular supply from the supraclavicular artery have been demonstrated before. The aim was to assess its versatility following an increase in pedicle length to be supplied by the transverse cervical artery, along with tunneling the pedicle under the sternocleidomastoid muscle to reach distant sites that the classic SCAIF could not reach.

Methods: A retrospective analysis was conducted of 25 consecutive patients in whom SCAIFs were performed to reconstruct remote head and neck postburn scars. Pedicle length, flap diameter, and complications were recorded with demographic and burn-related data.

Results: The study included 18 (72%) men and 7 (18%) women. The mean age was 15.7 years, and the mean injury time was 15 months before flap transfer. Isolated neck injury was the most affected site (44%). The mean length and width of the SCAIF were 16.6 and 6.5 cm, respectively. The mean length of its extended vascular pedicle based on transverse cervical artery was 7.2 cm. The donor site was closed primarily in all cases. All flaps survived completely, except 2 (8%) that exhibited partial necrosis.

Conclusions: The SCAIF is reliable for reconstructing postburn deformities in the head and neck region. Our results indicate that the increased pedicle length and the submuscular tunnel allow reliable distant flap transfer without the risk of excessive traction or vessel kinking.