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The use of a superficial circumflex iliac artery perforator flap obtained by a proximal to distal freestyle technique for the reconstruction of limb defects

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Abstract

Background

The superficial circumflex iliac artery (SCIA) perforator flap needs meticulous dissection because of anatomical variations. These variations of the SCIA allow the flap to be used in different parts of the body for different purposes. The aim of this study is to evaluate the versatility of using the SCIP flap in the reconstruction of composite defects in the upper and lower extremities.

Methods

Between 2017 and 2021, twenty-nine patients who had undergone reconstruction with SCIP flap and whose defects were located in the lower and upper extremities were included.

Results

The location of the defect was in the lower extremity in nine of the patients, and the upper extremity in twenty of the patients. The flap was raised from the superficial branch in thirteen of the patients, the deep branch in five of the patients, and the main trunk in eleven of the patients. The chimeric flap concept included both fascia and bone tissue other than the skin. Complications occurred in seven of the patients. Bone tissue loss occurred in one patient due to a perforator kink. Partial necrosis was encountered in four flaps, with two flaps failing, so the survival rate was 93.1%.

Conclusions

Although the SCIA has numerous anatomical variations, bringing certain difficulties, these variations can become an advantage when the anatomy of this region and microsurgical techniques are mastered. With the proximal to distal freestyle technique, the branch with sufficient calibration and pulsation can be safely selected from the superficial branch or deep branch.

Level of evidence: Level IV, Therapeutic

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Data Availability

All data has been recorded correctly.

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Funding

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Authors and Affiliations

  1. Department of Plastic, Reconstructive and Aesthetic Surgery, Bursa Konur Hospital, Bursa, Turkey

    Alper Aksoy

  2. Department of Plastic, Reconstructive and Aesthetic, Surgery, Acıbadem Taksim Hospital, Istanbul, Turkey

    M. Baver Acaban

  3. Department of Plastic, Reconstructive and Aesthetic Surgery, Mersin University Faculty of Medicine, Mersin, Turkey

    Şakir Ünal

Authors
  1. Alper Aksoy
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  2. M. Baver Acaban
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  3. Şakir Ünal
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Alper Aksoy, M. Baver Acaban and Sakir Ünal. The first draft of the manuscript was written by M. Baver Acaban and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Alper Aksoy.

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Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of University Mersin (28/04/2021/09–338).

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Informed consent was obtained from all individual participants included in the study.

Conflict of interest

Alper Aksoy, M. Baver Acaban, Şakir Ünal declare no conflict of interest.

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Aksoy, A., Acaban, M.B. & Ünal, Ş. The use of a superficial circumflex iliac artery perforator flap obtained by a proximal to distal freestyle technique for the reconstruction of limb defects. Eur J Plast Surg 46, 1177–1184 (2023). https://doi.org/10.1007/s00238-023-02075-z

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  • DOI: https://doi.org/10.1007/s00238-023-02075-z

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