PDF(Pubmed)
Abstract：
UNASSIGNED: Use of the supraclavicular artery island flap (SCAIF) in head and neck reconstruction has increased in recent years. Limited but improving experience among reconstructive surgeons with the procedure have exposed numerous issues associated with flap success. The objective of this study is to examine the role of flap size on viability.
UNASSIGNED: Retrospective case series.
UNASSIGNED: Tertiary Academic Medical Center.
UNASSIGNED: Review of patients undergoing SCAIF reconstruction between January 2014 and March 2022 was performed. Flap failure was defined as >50% skin paddle loss. The total flap surface area was examined. Multivariable analysis was performed to evaluate the association of other variables associated with flap failure.
UNASSIGNED: Eighty-nine supraclavicular island flaps were reviewed. Mean patient age was 63.2 ± 11.4 years. Fifty-five (61.2%) were male. Forty-five flaps (50.6%) were used for the reconstruction of defects of the skin of the neck/face. Twenty-nine flaps (32.6%) were utilized for defects of the pharynx/oropharynx, and 15 (16.9%) were utilized for oral cavity defects. Flap success rate was 94% (73/89). Flap site was not associated with flap failure (P = .46). Flaps >25 cm2 were 75% more likely to be successful. Multivariable logistic regression to assess the association of flap size in the context of other co-morbidities indicated flaps >25 cm2 were 3.6 times more likely to succeed regardless of co-morbidities, and patients with chronic obstructive pulmonary disease (COPD) have a 7-fold risk of flap failure (odds ratio: 7.3, 1.72-30.98, P = .007).
UNASSIGNED: An association with improved flap outcomes and larger skin paddles was observed in this series. The applicability of these observations to smaller flaps and larger series with more surgeons requires further study. Co-morbidities, particularly, COPD, continue to impact flap outcomes.
UNASSIGNED: Retrospective case series.
UNASSIGNED: Tertiary Academic Medical Center.
UNASSIGNED: Review of patients undergoing SCAIF reconstruction between January 2014 and March 2022 was performed. Flap failure was defined as >50% skin paddle loss. The total flap surface area was examined. Multivariable analysis was performed to evaluate the association of other variables associated with flap failure.
UNASSIGNED: Eighty-nine supraclavicular island flaps were reviewed. Mean patient age was 63.2 ± 11.4 years. Fifty-five (61.2%) were male. Forty-five flaps (50.6%) were used for the reconstruction of defects of the skin of the neck/face. Twenty-nine flaps (32.6%) were utilized for defects of the pharynx/oropharynx, and 15 (16.9%) were utilized for oral cavity defects. Flap success rate was 94% (73/89). Flap site was not associated with flap failure (P = .46). Flaps >25 cm2 were 75% more likely to be successful. Multivariable logistic regression to assess the association of flap size in the context of other co-morbidities indicated flaps >25 cm2 were 3.6 times more likely to succeed regardless of co-morbidities, and patients with chronic obstructive pulmonary disease (COPD) have a 7-fold risk of flap failure (odds ratio: 7.3, 1.72-30.98, P = .007).
UNASSIGNED: An association with improved flap outcomes and larger skin paddles was observed in this series. The applicability of these observations to smaller flaps and larger series with more surgeons requires further study. Co-morbidities, particularly, COPD, continue to impact flap outcomes.
摘要：
■近年来，锁骨上动脉岛状皮瓣（SCAIF）在头颈部重建中的使用有所增加。在手术的重建外科医生中，有限但不断改善的经验暴露了与皮瓣成功相关的许多问题。这项研究的目的是检查皮瓣大小对生存能力的作用。
■回顾性病例系列。
■第三级学术医学中心。
■对2014年1月至2022年3月期间接受SCAIF重建的患者进行审查。皮瓣失效定义为>50%的皮肤桨损失。检查皮瓣的总表面积。进行多变量分析以评估与襟翼故障相关的其他变量的关联。
■对89个锁骨上岛状皮瓣进行了回顾。患者平均年龄为63.2±11.4岁。55（61.2％）为男性。45个皮瓣（50.6％）用于重建颈/面部皮肤缺损。29个皮瓣（32.6％）用于咽/口咽缺损，15例(16.9%)用于口腔缺损。皮瓣成功率为94%(73/89)。皮瓣部位与皮瓣失败无关（P=0.46）。>25cm2的襟翼成功的可能性增加了75%。多变量逻辑回归来评估其他合并症背景下皮瓣大小的关联，表明>25cm2的皮瓣成功的可能性是无论合并症如何的3.6倍。慢性阻塞性肺疾病（COPD）患者皮瓣失败的风险是7倍（比值比：7.3，1.72-30.98，P=.007）。
■在该系列中观察到与改善的皮瓣结果和更大的皮肤桨相关。这些观察结果对更小的皮瓣和更多外科医生的更大系列的适用性需要进一步研究。共病,特别是,COPD,继续影响襟翼结果。
■回顾性病例系列。
■第三级学术医学中心。
■对2014年1月至2022年3月期间接受SCAIF重建的患者进行审查。皮瓣失效定义为>50%的皮肤桨损失。检查皮瓣的总表面积。进行多变量分析以评估与襟翼故障相关的其他变量的关联。
■对89个锁骨上岛状皮瓣进行了回顾。患者平均年龄为63.2±11.4岁。55（61.2％）为男性。45个皮瓣（50.6％）用于重建颈/面部皮肤缺损。29个皮瓣（32.6％）用于咽/口咽缺损，15例(16.9%)用于口腔缺损。皮瓣成功率为94%(73/89)。皮瓣部位与皮瓣失败无关（P=0.46）。>25cm2的襟翼成功的可能性增加了75%。多变量逻辑回归来评估其他合并症背景下皮瓣大小的关联，表明>25cm2的皮瓣成功的可能性是无论合并症如何的3.6倍。慢性阻塞性肺疾病（COPD）患者皮瓣失败的风险是7倍（比值比：7.3，1.72-30.98，P=.007）。
■在该系列中观察到与改善的皮瓣结果和更大的皮肤桨相关。这些观察结果对更小的皮瓣和更多外科医生的更大系列的适用性需要进一步研究。共病,特别是,COPD,继续影响襟翼结果。
