RESUMO
Objective @#To explore the clinical application of an extended clavicular epithelial flap with a transverse cervical arterial blood supply in the repair of postoperative soft tissue defects in elderly patients with oral cancer.@*Methods@#From January 2015 to June 2018, 24 elderly patients with oral cancer were admitted to the Department of Oral and Maxillofacial Surgery, Hainan Provincial People′s Hospital, including 15 males and 9 females, aged 65-82 years, with an average age of 71.8 years. The supraclavicular epithelial flap was used to repair the soft tissue defect after radical resection of the oral cancer. The flap was at least 4 cm × 6 cm, and the maximum size was 7 cm × 9 cm. All patients completed a University of Washington Quality of Life (UW-QOL) survey 6 months after surgery, and a subjective satisfaction survey was conducted.@*Results @#The prolonged clavicular epithelial flap survival rate was 91.6% (22/24). The patients had good speech and swallowing function, hidden scars and no obvious sequelae. The average UW-QOL score 6 months after the operation was 76.5 ± 6.4. The follow-up satisfaction rate was 87.5% (21/24).@*Conclusion@#An extended clavicular epithelial flap with a transverse cervical arterial supply is reliable, of moderate thickness, is simple to implement, causes little trauma at the donor site, and yields a relatively concealed donor site. It is suitable for the simultaneous repair of soft tissue defects in elderly patients with oral cancer.
RESUMO
It is no doubt that flaps for resurfacing the face and neck should have appropriate thickness and good color match. Tissue expansion has been widely used for this purpose but, its result may be sometimes disappointed for resurfacing the face and neck, especially anterior neck, because of obtuse cervicomental angle. For resurfacing, various techniques such as tissue expansion, postauricular free flap and submental flap have been used and supraclavicular flap was also provided as a good tool with good color and texture match. In the aspect of easy approach for neighboring face and neck resurfacing, supraclavucular area can be recommended as the first choice of flap selection. We experienced 8 patients who require to resurface the face and neck by using supraclavicular flap and we obtained good results without complications. All the flaps were based on the supraclavicular pedicle originated from transverse cervical artery and various pattern of modification such as expanded, supercharged or free flap. Patients were listed with postburn contracture or posttraumatic deformity and supraclavicular flap was used as a free flap in 4 cases and an island flap in 4 cases. Supraclavicular flap as a free flap is one of ideal methods for face and upper neck resurfacing and may be used for neck reconstruction as an island flap. Although tissue expansion of neck was not ideal for resurfacing of low face and anterior neck, but it was effective for lateral neck and infraauricular region resurfacing with insertion of tissue expander into supraclavicular area. In conclusion, supraclavicular flap can be effectively used as various patterns including expansion, island flap and free flap without noticeable donor scar.