Pre-expanded ultra-thin supraclavicular flaps for (full-) face reconstruction with reduced donor-site morbidity and without the need for microsurgery.

Abstract

The expanded supraclavicular island flap, as described in 1997 by the senior author (Pallua), is a useful tool for total facial reconstruction, providing satisfactory results without microsurgical prefabrication. The authors report the use of this technique in 12 patients requiring large flaps who presented with extensive facial scarring that had been previously reconstructed using disfiguring, pigmented skin grafts. On the basis of their anatomical dissection studies and knowledge of the constant anatomy of the supraclavicular artery and two draining veins, the authors carefully inserted tissue expanders under the supraclavicular island flaps. After the flaps were expanded, all scars were removed and the covering flaps were transferred into place. Sixteen pre-expanded supraclavicular island flaps were used in 11 patients. There were no complications. The authors present a method of facial reconstruction that has the advantages of creating a large amount of thin tissue of both good color and texture, without the disadvantages of donor-site morbidity, lengthy operative time, and high cost. In their opinion, this is the method of choice for total facial reconstruction.