Reconstructions of Head–Neck, Upper and Lower Extremities Using Free Scip Flap: a Retrospective Analysis of 18 Cases
4th International Microsurgery Meeting Izmir, İzmir, Turkey, 26 - 28 September 2025, pp.8-11, (Full Text)
- Publication Type: Conference Paper / Full Text
- City: İzmir
- Country: Turkey
- Page Numbers: pp.8-11
- Bursa Uludag University Affiliated: Yes
Abstract
Introduction: The Superficial Circumflex Iliac Artery Perforator (SCIP) flap, first described by Koshima et al. in 2004, has gained increasing popularity in microsurgical reconstruction owing to its advantages of low donor-site morbidity, thin and pliable tissue composition and aesthetically concealable donor-site scar. In head and neck reconstruction, it provides reliable results, especially after oncologic resections with wide and complex defects; while in upper extremity defects—particularly dorsal hand and finger reconstructions—it allows for multilobular, chimeric, and supercharged designs, achieving both functional and aesthetic benefits.
Aim: This study aimed to evaluate the outcomes of free SCIP flap reconstructions performed in our clinic, to outline the surgical details, and to compare the findings with the current literature.
Methods: A retrospective review was conducted on 18 patients who underwent free SCIP flap reconstruction between 2018 and 2025 at the Department of Plastic, Reconstructive and Aesthetic Surgery, Uludağ University. Patient demographics, defect locations and dimensions, recipient vessel selection, etiology, complications, and follow-up outcomes were analyzed. Findings were compared with current literature in terms of functional and aesthetic outcomes in head–neck and upper extremity reconstructions.
Results: The mean age was 47.7 years (range: 12–83); 15 patients were male (83.3%) and 3 female (16.6%). Defects were located in the upper extremity in 10 cases (4 dorsal hand, 3 finger, 2 wrist, 1 forearm), head–neck in 7 cases, and lower extremity in 1 case. The mean defect size was 74.4 cm² (10–170). Recipient arteries included the radial (n=6), ulnar (n=2), superficial temporal (n=2), superior thyroid (n=3), and other vessels. Etiologies were trauma in 10 cases (4 gunshot wounds, 2 crush injuries, 4 sharp object lacerations) and malignancy in 7 cases (5 SCC, 1 BCC, 1 thyroid carcinoma, 1 adenoid cystic carcinoma). Mean follow-up was 6.7 months (1–26). The overall complication rate was 33.3%: 2 partial (11.1%) and 2 total (11.1%) necroses, 1 venous (5.5%) and 1 arterial (5.5%) thrombosis. Total flap survival rate was 88.8%.
Conclusion: The SCIP flap represents one of the most significant advances in perforator flap surgery over the past two decades and is currently regarded as a “workhorse flap.” The survival rate obtained in this study is comparable with the high success rates reported in the literature. Complications were particularly associated with prior radiotherapy and high-energy trauma. The SCIP flap offers both functional and aesthetic satisfaction in head–neck reconstruction and preserves mobility while providing durable coverage in upper extremity defects. Its multilobular versatility enables reconstruction of complex finger defects, and its safety in elderly and comorbid patients constitutes a further advantage. Conclusion, the free SCIP flap is a reliable, functional, and aesthetic option for head–neck and extremity reconstructions.