Anatomical basis and clinical application of the superficial circumflex iliac artery perforator flap for the reconstruction of oral cavity defects following resection for oral squamous cell carcinoma
10.3760/cma.j.cn114453-20200217-00052
- VernacularTitle:旋髂浅动脉穿支皮瓣在口腔鳞癌术后修复重建中的解剖基础和临床应用
- Author:
Dajiang SONG
1
;
Bo ZHOU
;
Zan LI
;
Yixin ZHANG
;
Chunliu LYU
;
Yuanyuan TANG
;
Liang YI
;
Zhenhua LUO
Author Information
1. 湖南省肿瘤医院肿瘤整形外科，长沙 410008
- Keywords:
Surgical flaps;
Perforator flap;
Superficial circumflex iliac artery;
Anatomy;
Oral squamous carcinoma;
Reconstructive surgical procedures
- From:
Chinese Journal of Plastic Surgery
2022;38(1):40-45
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the anatomical basis and the clinical effect of superficial circumflex iliac artery perforator (SCIP) flap in repairing defects after radical resection of oral squamous cell carcinoma.Methods:Bilateral superficial circumflex iliac artery and vein were dissected in ten fresh cadavers. From June 2017 to June 2019, the patients with oral squamous carcinoma received resection and reconstructed with SCIP flap immediately. Before the operation, the locations of SCIP were detected and marked by Doppler. According to the size of the defect in the oral cavity, SCIP flaps were designed and raised, then transferred to the defect area of the oral cavity. The arteries and veins were anastomosed under a microscope. The survival and functional recovery of the flap were evaluated after the operation. Patients were followed up for 6-30 months.Results:The bilateral dissection of fresh cadavers yielded anatomical data of 20 superficial circumflex iliac arteries and veins. The diameter of the circumflex iliac artery was (1.94±0.30) mm, with a superficial branch [mean diameter, (0.94 ± 0.25) mm)] and a deep branch[mean diameter, (1.25 ± 0.27) mm)]. At least two (2.15 ± 0.37) myocutaneous perforators arose from the deep branch that passed through the sartorius muscle. The diameter of the myocutaneous perforator was (0.75±0.15) mm. The diameter of the circumflex iliac vein was (1.72±0.14) mm. The pedicle length of the superficial branch was (6.5±1.2) cm, the pedicle length of the deep branch was (8.5±1.9) cm, and the pedicle length of the vein was (9.2±2.1) cm. Sixteen patients with 14 males with oral squamous carcinoma were included, aged from 31 to 70 years (average, 48.8 years). The flap size ranged from 6 cm×4 cm to 12 cm×6 cm. The mean pedicle length of the artery was 6.8 cm, and the mean pedicle length of the vein was 7.6 cm. One flap suffered from venous congestion postoperatively and was lost ultimately. The other flaps all survived. Two patients were noted with donor site lymphatic fistula, and the drainage tube removal was delayed. Patients were followed up for 6-30 months. One patient was noted with cervical metastasis nine months after the operation. No recurrence or metastasis was found in other patients during the follow-up period. No donor-site-related complication occurred, and all patients were satisfied with the recovery of the oral function.Conclusions:The SCIP flap is a good choice for the reconstruction of oral cavity defects following resection for oral squamous cell carcinoma with the proper thickness, soft texture, constant diameter and length of vascular pedicle, stable blood supply, and concealed donor site.
