Superficial Circumflex Iliac Perforator Free Flap for Soft Tissue Coverage of Wrist and Hand Defects

The soft tissue defect of the wrist and the hand often exposed important structure easily, so it need to be covered early by  good materials. In the past, the fasciocutaneous flaps of forearm are widely used to cover this area. However, these flaps have two disadvantages, to sacrifice main artery of forearm and/or to have a bad scars in flap donor site. Superficial circumflex iliac perforator free flap (SCIP flap) is an other choice for soft tissue coverage of wrist and hand defects with some advantages such a s: thin flap, good material, reliable, no need debulking surgery, and it can cover the large areas with an aesthetic improvement scars in flap donor site. But clinical data of SCIP flap has not much. Therefore, a clinical study is required to assess the results of using of SCIP flap for soft tissue coverage of wrist and hand defect.

A case series, prospective study design was used. From september, 2020 to september 2022, in the Departement of Microsurgery and Reconstruction at Hospital for Traumatology and Orthopeadics Ho Chi Minh City, 8 patients with 8 SCIP flaps were raised for covering soft tissue of wrists and hands defects, exposing of tendons, bone. Patients have been monitored at least 2 months for evaluating the condition of flaps.

All flaps survived. However, marginal necrosis was observed in one case and one flap suffered from venous congestion followed by distal superficial necrosis; nevertheless, it completely healed after 20 days. All patients had the donor site directly closed.The flaps dimension were as large as 8 x 12 cm. This flap can cover many sides of wrist and hand: wrist (1 cases), dorsal of hand (2 cases), volar of hand (2 cases), stump hand (2 cases), and finger 5th (1 case). No patient complained of any sensory deficit.

The SCIP flap provided reliable coverage of soft tissue defects of the hand and wrist. The flap can be raised with large dimensions. SCIP flaps are thin, reliable and versatile. All of cases, the donor site may be closed primarily with aesthetic scars.

Keywords: superficial circumflex iliac perforator free flap, groin free flap.