The supraclavicular artery island flap (SCAF) has been widely described in the reconstruction of head and neck defects with the return of popularity following the description of its vascular supply by Pallua et al1. Benefits include the well described anatomy, good colour/texture match, ease of harvest and minimal donor site morbidity1. Our series supports the utilities for the SCAF in a regional centre as well as new indications which have not been previously described.
A single surgeon case series from a regional institution from 2020 to 2022 in which supraclavicular flaps have been used in head and neck reconstruction. Cases were selected if the SCAF was available, able to reconstruct the skin defect and the donor site was deemed to be able to be closed directly.
Patients were aged 80 years or older. Indications included cancers for primary disease, recurrent disease and irradiated fields. The flap was used for volume and contour correction and in the setting of symmetry surgery for facial palsy. All flaps were islanded, donor sites closed directly and the inset flap went on to heal with no flap loss. The pedicle resulted in a cord or tented appearance and donor site was thin over the clavicle and the scars appeared stretched.
For the elderly and comorbid cohort of head and neck patients, the SCAF offered a reliable and technically simpler alternative to free flap reconstruction with comparable outcomes, shorter operative time, less ICU stay, and less demanding postoperative monitoring.