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Head and neck tissue defects after ablative head and neck surgery often require complex and composite reconstructions. The superficial circumflex iliac artery perforator (SCIP) flap is an extremely versatile perforator-based flap with minimal donor-site morbidity. The authors present their experience with both simple and chimeric SCIP flap reconstructions for complex defects in various head and neck regions.Twenty-two patients undergoing ablative head and neck surgery for oncologic abnormalities were treated by means of a SCIP flap reconstruction. Patients' mean age was 62 years; 21 were men and one was a woman. Seventeen flaps were simple and five were chimeric reconstruction patterns. Indocyanine green perfusion imaging was performed in all cases.Twenty-one of 22 patients (95.5 percent) were successfully treated with good aesthetic and functional results. Two patients (9 percent) showed minor donor-site complications that were managed conservatively. The mean follow-up period was 5.3 months (range, 2 to 8 months).This case series demonstrates the reliability and versatility of the SCIP flap for head and neck reconstruction. The chimeric options combined with bone, double-skin paddle, and muscle offer a broad variety of functional reconstructive solutions for complex head and neck surgery. Intraoperative indocyanine green perfusion examinations are a valuable tool to assess and ascertain proper inset, vitality, and postanastomosis vessel patency in these complex microvascular flap reconstructions. .Therapeutic, IV.

Background:The purpose of this study was to compare the clinical outcomes and donor-site morbidity between the suprafascial and subfascial harvesting of anterolateral thigh flaps.Methods:Sixty-one patients who underwent free flap reconstruction (30 suprafascial and 31 subfascial anterolateral thigh

Understanding the precise anatomy in experimental animals is crucial for correct design of research projects. Rats are commonly used for scientific research in plastic surgery because of their availability in academic institutions, moderate cost, and sizable vessels for microsurgical procedures. In past publications about rat anatomy, lymphatic mapping has been limited and incomplete. The aim of this study was to comprehensively map the superficial lymphatic system in the rat.Twenty-seven Sprague-Dawley rats were used for this study. Indocyanine green fluorescence lymphography was used to identify the lymphatic vessels and lymph nodes. Under general anaesthesia, indocyanine green was injected intradermally at multiple spots along the dorsal and medial midlines, front and hind paws, ears, and tail. The course of the lymphatic vessels was traced on the skin with a marker pen and photographed. The superficial lymphatic vessels in each rat were sketched on a graphic template and all of the templates were superimposed using graphics software to define the relationship between the lymphatic vessel and sentinel node.Indocyanine green fluorescence lymphography was able to demonstrate the superficial lymphatic vessels in the rat. Six groups of regional lymph node/s were identified and lymphatic pathways to those nodes delineated. The authors' lymphosome concept was successfully applied to the rat, with six lymphosomes identified.The authors succeeded in performing superficial lymphatic mapping in the rat. The authors' anatomical findings can provide further information about the lymphatic system in the normal state and promote understanding of pathologic changes generated by surgical manipulation for future studies.

BACKGROUND: The authors present the posteromedial thigh flap as an alternative source for head and neck reconstruction, and the perforator patterns and vascular anatomy of this flap were further investigated. METHODS: From March to August of 2014, 23 patients underwent head and neck reconstruction with 23 posteromedial thigh flaps. The numbers, locations, and types of perforators were measured. The surgical technique and the results after reconstruction were evaluated. RESULTS: Most perforators were located 8 to 10 cm away from the pubic crease on the reference line between the perineum and the insertion of the semitendinosus muscle. The average number of perforators was 1.7 (range, 1 to 3), and the average pedicle length was 10.3 cm (range, 8 to 13 cm). Eighty percent of the perforators (32 of 40) were musculocutaneous, and 20 percent (8 of 40) were septocutaneous. Ninety-five percent of the perforators (38 of 40) originated from the profunda femoris artery, and 5 percent (two of 40) originated from the medial circumflex femoral artery. The flap survival rate was 95.6 percent; one flap failed due to pedicle thrombosis. The donor sites were all closed primarily. CONCLUSIONS: The location of the perforators of the posteromedial thigh flap is consistent, and the pedicle length is sufficient to reach the neck region. Different reconstruction demands can be met by incorporating various soft-tissue components. The donor-site scar is well concealed, with minimal morbidity. The above advantages make the posteromedial thigh flap an excellent option for head and neck reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.