Supraclavicular flap repair in the free flap era
Research article published in ANZ journal of surgery (2018)
Abstract
BACKGROUND: Supraclavicular flap (SCF) repair is widely reported in head and neck surgery in select patients and defects. The authors' objective is to present our series of 30 patients who underwent SCF repair for varying defects and to review the scope and outcome of SCF repair in the literature. METHODS: The authors contributed primary evidence of 30 cases of SCF repair. Our outcomes are compared with those reported in the last 5 years' literature; 33 articles published between January 2012 and January 2017 that present original clinical experience of 528 SCFs. RESULTS: SCF is suitable for a wide variety of oral cavity, pharyngeal, skull base and cutaneous defects. Consistent with our experience, SCF is highly reliable even in previously irradiated or dissected necks, so long as the supraclavicular artery is intact. Our case series shows minor complications in 3/30 (10%) and flap loss in 1/30 (3.3%) cases. The literature reports a similar rate of complete flap failure of 3.4% and a slightly higher average minor complication rate of 24.6%. CONCLUSION: We add our experience of 30 cases of SCF repair to the international literature. We experienced a complication rate lower than the reported average, and maintain that the SCF is an excellent reconstructive option in patients with previously irradiated necks or comorbidities that affect microvasculature and anaesthetic resilience.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.
Why This Matters for Hirudotherapy
This paper reports a single-team series of 30 supraclavicular flap (SCF) reconstructions alongside a review of 528 SCFs from the recent literature, finding the pedicled SCF highly reliable for head, neck, and oral-cavity defects, including in previously irradiated or dissected necks, with reported complete flap failure around 3 to 3.4% and minor complications of roughly 10% in their series versus about 24.6% in the literature. It is relevant to hirudotherapy because flap reconstruction is the broader clinical arena where venous congestion of a compromised flap can prompt adjunctive leech therapy; understanding when a robust pedicled option like the SCF is chosen helps frame where congestion-salvage tools are and are not needed. As a small case series combined with a literature review and no comparison group or any mention of leech use, it offers descriptive reliability data rather than controlled evidence.
Citation
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