The Supraclavicular Flap—Indications, Execution and Outcomes in Head and Neck Reconstruction

BACKGROUND: The supraclavicular flap (SCF) is a well-established reconstructive option for defects of the head and neck. It combines the pliability of a fasciocutaneous flap with the benefits of locoregional reconstruction. These characteristics enable the flap to be widely applicable in the head and neck region. METHOD: The anatomy and surgical execution for the supraclavicular flap is reviewed with emphasis on the decision-making process pre- and intra-operatively to improve success along with illustration of a case series of patients. RESULTS: In a retrospective case series of 18 patients in a single institution, the SCF was utilised both as primary and salvage options in head and neck reconstruction. The indications for SCF included skin and soft tissue resurfacing (n = 9), comorbid patients not eligible for free flaps (n = 7) and in salvage surgery (n = 2). We had three flap related complications requiring return to theatre to facilitate healing prior to commencement of post-operative radiotherapy. These included two cases of minor dehiscence which were re-debrided and inset; and one case of flap tip necrosis which was treated with debridement and skin grafting. CONCLUSION: The supraclavicular flap is a reliable option for locoregional head and neck reconstruction. It also has several advantages over more traditional options such as the pectoralis major flap, providing a more functional and aesthetic result with close to ideal skin colour, pliability, and contour.