MANAGEMENT OF HAND DEFECT WITH PEDICLED SUPERFICIAL CIRCUMFLEX ILIAC PERFORATOR (SCIP) FLAP: NOH, DALA KANO AND LASUTH, IKEJA EXPERIENCE

Superficial circumflex iliac artery perforator flaps

Abstract

MANAGEMENT OF HAND DEFECT WITH PEDICLED SUPERFICIAL CIRCUMFLEX ILIAC PERFORATOR (SCIP) FLAP:  NOH, DALA KANO AND LASUTH, IKEJA EXPERIENCE

Authors: Ajani A, Alimi MF, Adesina AA, Waziri AM, Suleiman HM, Gbadamasi KA, Bolaji AI, Atoyebi S.A

Background: Superficial circumflex perforator (SCIP) flap was first popularized in 2004 by Koshima. Its versatility has been employed as option for coverage of hand defect either as a pedicle or free flap. This flap can also be employed as a workhorse flap for coverage for large hand defects, it’s easy to harvest, with negligible donor site morbidity. This study aimed to share our experience with the use of SCIP flap for reconstruction of hand defect.

Methodology: A retrospective study of 21 patients with hand defects who had ipsilateral SCIP flap coverage between May 2018 and April 2021.The demographic characteristics, aetiology of hand defect, distance of perforator from superficial circumflex iliac artery (SCIA) as identified using handheld doppler and outcome were analysed.  All cases were done in 3 stages (elevation, division and in setting).

Results: 66.7% of patients were males (n=14). The defect was mostly posttraumatic (71.4%). The defects range from 6x 4 cm to 14x8cm in their widest dimensions. A pedicled SCIP was used in all cases. The SCIA perforator was within 5cm to the pubic tubercle. Only in 3 cases (14.3%) was the donor site closed with skin graft. Post-operative complication was seen in 2 patients as flap tip necrosis. All the patients did not require flap debulking. Mean follow-up period was 9months

Conclusion: SCIP flap is valuable in coverage of extensive hand defects, often without need for debulking surgery and minimal donor site morbidity.