A clinical experience of the supraclavicular flap used to reconstruct head and neck defects in late-stage cancer patients

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author ALVES, Helio R. N. FMUSP-HC
ISHIDA, Luis C. FMUSP-HC
ISHIDA, Luis H. FMUSP-HC
BESTEIRO, Julio M. FMUSP-HC
GEMPERLI, Rolf FMUSP-HC
FARIA, Jose C. M. FMUSP-HC
FERREIRA, Marcus C. FMUSP-HC
dc.date.issued 2012
dc.identifier.citation JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY, v.65, n.10, p.1350-1356, 2012
dc.identifier.issn 1748-6815
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/298
dc.description.abstract The supraclavicular island flap has been widely used in head and neck reconstruction, providing an alternative to the traditional techniques like regional or free flaps, mainly because of its thin skin island tissue and reliable vascularity. Head and neck patients who require large reconstructions usually present poor clinical and healing conditions. An early experience using this flap for late-stage head and neck tumour treatment is reported. Forty-seven supraclavicular artery flaps were used to treat head and neck oncologic defects after cutaneous, intraoral and pharyngeal tumour resections. Dissection time, complications, donor and reconstructed area outcomes were assessed. The mean time for harvesting the flaps was 50 min by the senior author. All donor sites were closed primarily. Three cases of laryngopharyngectomy reconstruction developed a small controlled (salivary) leak that was resolved with conservative measures. Small or no strictures were detected on radiologic swallowing examinations and all patients regained normal swallowing function. Five patients developed donor site dehiscence. These wounds were treated with regular dressing until healing was complete. There were four distal flap necroses in this series. These necroses were debrided and closed primarily. The supraclavicular flap is pliable for head and neck oncologic reconstruction in late-stage patients. High-risk patients and modified radical neck dissection are not contraindications for its use. The absence of the need to isolate the pedicle offers quick and reliable harvesting. The arc of rotation on the base of the neck provides adequate length for pharyngeal, oral lining and to reconstruct the middle and superior third of the face.
dc.language.iso eng
dc.publisher ELSEVIER SCI LTD
dc.relation.ispartof Journal of Plastic Reconstructive and Aesthetic Surgery
dc.rights restrictedAccess
dc.subject Supraclavicular flap; Head and neck; Reconstruction; Cancer
dc.subject.other artery island flap; pectoralis-major; cervicohumeral flap; anatomy
dc.title A clinical experience of the supraclavicular flap used to reconstruct head and neck defects in late-stage cancer patients
dc.type article
dc.rights.holder Copyright ELSEVIER SCI LTD
dc.description.conferencedate NOV 11-15, 2010
dc.description.conferencelocal Vitoria, BRAZIL
dc.description.conferencename 47th Brazilian Congress of Plastic Surgery
dc.description.group LIM/04
dc.identifier.doi 10.1016/j.bjps.2012.04.050
dc.identifier.pmid 22658776
dc.type.category article; proceedings paper
dc.type.version publishedVersion
hcfmusp.author ALVES, Helio R. N.:HC:ICESP
hcfmusp.author ISHIDA, Luis C.:HC:ICHC
hcfmusp.author ISHIDA, Luis H.:HC:ICHC
hcfmusp.author BESTEIRO, Julio M.:FM:MCG
hcfmusp.author GEMPERLI, Rolf:FM:MCG
hcfmusp.author FARIA, Jose C. M.:HC:ICHC
hcfmusp.author FERREIRA, Marcus C.:FM:MCG
hcfmusp.origem.id WOS:000308995700016
hcfmusp.origem.id 2-s2.0-84866407041
hcfmusp.publisher.city OXFORD
hcfmusp.publisher.country ENGLAND
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dc.description.index MEDLINE
hcfmusp.citation.scopus 38
hcfmusp.citation.wos 37


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