Versatility of the Superficial Circumflex Iliac Artery Perforator Flap in Head and Neck Reconstruction

The superficial circumflex iliac artery perforator (SCIP) flap was first reported in 2004, in which the concept of perforator flap was incorporated into the groin flap. Although a SCIP flap has many advantages, reports on its application to head and neck defects are limited. We present cases of SCIP flap transfer for reconstruction of various types of head and neck defects. Twelve patients underwent reconstruction using the free SCIP flap after tumor ablative surgery in the head and neck region. The flap was elevated based on the perforators of the superficial branch and/or deep branch of the superficial circumflex iliac artery. The thickness of the flap was adjusted according to the defect. The Photo Dynamic Eye infrared camera system using indocyanine green was used to detect the location of the perforators preoperatively and to confirm the blood flow after elevation of the flap. The flaps survived completely in all the cases. The mean pedicle length was 7.1 cm (range, 6-9 cm), and the mean flap size was 12.8 x 6.3 cm (range, 4 x 2 to 18 x 8 cm). No vein grafting was necessary in any patient. The advantages of the SCIP flap include 1) low donor-site morbidity; the donor site is in a hairless concealed area, primary donor-site closure is possible, and no muscular dissection is necessary; 2) adjustable thickness of the flap from a superthin flap to a bulky flap; and 3) a long vascular pedicle available. We believe that the SCIP flap will become one of the most versatile options in head and neck reconstruction.