Background: The supraclavicular artery island flap is a pedicled flap that offers a versatile reconstructive option for head and neck defects. Recent anatomical studies have improved our understanding of the vascular supply of the supraclavicular artery island flap. At our hospital, the supraclavicular artery island flap (SCAIF) has become a reliable option for fasciocutaneous coverage of complex head and neck defects. This study aims to describe the modified type of the supraclavicular artery flap in head and neck oncologic defects and reconstructive results. Methods: A case series study of head and neck cancer who were treated by radical surgery or salvage surgery with reconstruction between January 2020 and March 2021 in HCMC Oncology Hospital
a prospective study. We assessed reconstructive techniques and outcomes. Results: Seventeen cases underwent reconstructive surgery by supraclavicular artery island flap of which 15 were males and 2 females. The mean age was 49.6 (39-69 years old). Cases included carcinoma of the hypopharynx & larynx (13 cases), pharyngeal posterior wall (1 case) and squamous cell skin cancer (3 cases), staged III, IVA according to 8th AJCC Classification - 2017 or recurrence after initial therapy. Defects of the hypopharynx (4 cases), pharyngeal esophagus (5 cases), pharyngeal tongue base (2 cases), cervical esophagus (3) and cervico - facial skin were immediately reconstructed, the mean skin defect size was 10 cm × 17 cm
the smallest flap was 6 x 10 cm and the largest size was 11 x 26 cm. Our results with complete flap survival in 16/17 cases, a partial flap survival in one patient which required additional another flap. Three patients developed a pharyngeocutaneous fistula, 2 of which were wound infection and prolonged wound care (who had a history of previous radiation) and 1 case of partial flap loss mentioned above. All donor sites were closed primarily. There was no serious donor - site morbidity. Most patients fully recover their ability to swallow within two weeks after surgery and there was a restoration of sensation on the flap
the cosmetic result was excellent for 3 cases of skin cancer Conclusions: The modified type of supraclavicular artery island flap is a thin versatile, safe, reliable, sensate, pliable fasciocutaneous pedicled flap that has low morbidity, with the good cosmetic and the functional outcome at both of recipient and donor - site, suitable for reconstructing of soft tissue in head and neck region.