The Superficial Circumflex Iliac Artery Perforator Flap

Abstract

The superficial circumflex iliac artery perforator (SCIP) flap is a relatively new modification of the traditional pedicled groin flap. The groin flap is an axial flap that utilizes the superficial circumflex iliac artery (SCIA) that lies caudal to the inguinal ligament. The SCIP flap utilizes a perforator from the SCIA that branches off the SCIA usually in the midpoint of the inguinal ligament and travels superior to it. It then courses parallel to the inguinal ligament about 2 cm superior to it. As a perforator flap, it does not sacrifice any muscle and the level of dissection is just below the Scarpa’s fascia. The superficial circumflex iliac vein (SCIV) is usually included in the flap to aid with drainage and the superficial inferior epigastric vein (SIEV) may be incorporated as well if its territory is included in the flap design. The SCIP flap is an excellent option in non-obese individuals for reconstructing distal extremity defects since it is a thin flap that avoids the excessive bulk seen with other reconstructive options. The dissection is relatively easy; however, the pedicle can often be short and the diameter of the vessels small, making microsurgical anastomosis more challenging compared to other more traditional flaps and oftentimes require super-microsurgery techniques for a successful result. We prefer to use this flap in patients with normal BMI who do not have diabetes and do not smoke. Due to the small size of vessels, an end-to-end anastomosis with a named vessel is usually difficult. We prefer to perform an end-to-side anastomosis with a named vessel.