Superficial Cervical Artery Flapskin flap. Plast Reconst Surg 2004; 114: 95e¡97e. 4,Rei Ogawa, Hiko...
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Key words: $"%# Superficial cervical artery(SCA)flap <!z^ qH[/!3;^q-CQ:2Ew© (superficial cervical artery)HN¤bZ72E 6*E 1 "GFGF<!Ho©¨hgn; ic:£+5/4.!BDOXJ6*EAx ]98:@P£1! ¥715;k£@`d1 4 2,3 "a;_~:,+5<^a-C^a!bZa =7U¦14">4!R@l?!0C:3;Iy r;fq7uK;WH:OJ: !' &! Superficial Cervical Artery Flap $20 \;`d73;$ }q t¢ 1 { e 2 pv § 2 1 LSY|M_sVS 2 LSY|M_sVS#¡VS The Superficial Cervical Artery Flap: Twenty Years% Experience and Development of the Flap Masahiro Murakami 1 , Hiko Hyakusoku 2 and Rei Ogawa 2 1 Department of Plastic and Reconstructive Surgery, Nippon Medical School Second Hospital 2 Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital Abstract The superficial cervical artery(SCA)is a superficial branch of the transverse cervical artery. The SCA supplies the upper part of the trapezius muscle. Since 1986, we have harvested SCA flaps for the reconstruction of neck scar contractures and intractable ulcers of the parietal region. We developed the SCA flap for use as a skin flap in 1990, and in 1993 we succeeded in harvesting it as a free flap. We first employed the flap with a musculocutaneous pedicle, but later we developed the flap as a muscle pedicled flap and a vascular pedicled flap. Moreover, we have successfully employed the flap as a &Super-thin flap!' and as microvascular augmented flaps for harvesting extremely large flaps safely. In the 1980s and early 1990s the concept of &perforator flaps' was unknown, but the SCA is now considered to be a perforator. Thus, we can call the flap the SCA perforator (SCAP) flap. The SCAP flap has a wide rotation arc and low donor-site morbidity, and our clinical studies clearly show that it is useful for reconstruction. (LSYLYTjm 2006; 2: 12$17) superficial cervical artery perforator flap, superficial cervical artery flap, perforator flap, trapezius muscle, superficial cervical artery Correspondence to Masahiro Murakami, Department of Plastic and Reconstructive Surgery, Nippon Medical School Second Hospital, 1$396 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa 211$8533, Japan E-mail: [email protected] Journal Website(http:!! www.nms.ac.jp! jmanms! ) 12 LLTm 2006; 2 (1)
Transcript of Superficial Cervical Artery Flapskin flap. Plast Reconst Surg 2004; 114: 95e¡97e. 4,Rei Ogawa, Hiko...
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Key words:
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The Superficial Cervical Artery Flap:Twenty YearsExperience and Development of the Flap
Masahiro Murakami1, Hiko Hyakusoku2 and Rei Ogawa21Department of Plastic and Reconstructive Surgery, Nippon Medical School Second Hospital
2Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital
Abstract
The superficial cervical artery�SCA�is a superficial branch of the transverse cervicalartery. The SCA supplies the upper part of the trapezius muscle. Since 1986, we haveharvested SCA flaps for the reconstruction of neck scar contractures and intractable ulcers ofthe parietal region. We developed the SCA flap for use as a skin flap in 1990, and in 1993 wesucceeded in harvesting it as a free flap. We first employed the flap with a musculocutaneouspedicle, but later we developed the flap as a muscle pedicled flap and a vascular pedicled flap.Moreover, we have successfully employed the flap as a Super-thin flap� and asmicrovascular augmented flaps for harvesting extremely large flaps safely. In the 1980s andearly 1990s the concept ofperforator flapswas unknown, but the SCA is now considered tobe a perforator. Thus, we can call the flap the SCA perforator�SCAP�flap. The SCAP flap hasa wide rotation arc and low donor-site morbidity, and our clinical studies clearly show that it isuseful for reconstruction.�t(uvbwuw 2006; 2: 12e17�
superficial cervical artery perforator flap, superficial cervical artery flap,perforator flap, trapezius muscle, superficial cervical artery
Correspondence to Masahiro Murakami, Department of Plastic and Reconstructive Surgery, Nippon Medical SchoolSecond Hospital, 1e396 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa 211e8533, JapanE-mail: [email protected] Website�http:��www.nms.ac.jp�jmanms��
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図1 各種SCA flapのデザイン
A ：Cervicoscapular flap
B ：Cervicodorsal flap
C ：Microvascular augmented SCA flap
a ：superficial cervical vessels
b ：circumflex scapular vessels
c ：dorsal intercostal perforator
図2 茎の形態
MC:皮膚筋茎（musculocutaneous pedicle）
M:筋茎（muscle pedicle）
P:穿通枝茎（perforator pedicle）
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表1 症例と結果
付加血管束壊死（cm）皮弁サイズ（cm）茎再建部位皮弁年齢/性症例
――30×7Moccipital regionCD55/male 1
― 830×9MCaxillaCD41/female 2
― 530×7MCneckCD43/female 3
―1033×7MCneckCD
――32×12MCneckCS22/male 4
――32×12MCneckCS
――31×10MneckCS55/female 5
――25×10MneckCS
――28×12PneckCS32/male 6
――25×13MneckCS55/male 7
― 331×11MneckCS18/male 8
――30×10MneckCS35/male 9
――31×9MneckCS
――31×10PneckCS48/male10
――30×12PneckCS28/male11
――31×13MneckCS45/female12
――28×13Plower lipCS
――30×13PneckCS39/male13
――30×12Pparietal regionCS40/male14
――18×9Panterior chest wallCS56/female15
――27×9MneckCS55/female16
――30×10PneckCS21/male17
――28×10MneckCS48/female18
――30×12PcheekCS55/male19
――32×13PneckCS
――32×10PneckCS27/male20
―2533×15Plower lipCS
― 225×12freeforeheadCS60/male21
――15×6MneckCS6/male22
――22×7MaxillaCS11/female23
― 533×8PneckCS55/male24
――32×12PneckCS45/male25
――27×10freeforeheadCS36/male26
――22×8 Poccipital regionCS45/female27
――20×12Msuprascapular regionCS54/male28
――12×6MCnapeCS67/male29
――14×6MCnapeCS
CSAV 723×18MneckCS13/male30
7th DICP―26×9PneckCD59/male31
7th DICP―35×14MneckCD51/male32
CSAV＊―28×20Ｐneck～lower lip―37/female33
7th DICP 426×11freelower lip～submandibular regionCD34/female34
CD: cervicodorsal flap
CS: cervicoscapular flap
CSAV: circumflex scapular artery & vein（＊contralateral）
DICP: dorsal intercostal perforator
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図3 超薄化する以前の症例．
皮弁は厚く，輪郭形成が不十分である．
図4 皮弁を超薄化した症例．
a :超薄化終了時の臨床像．
b :表皮壊死のため色素沈着を生じたが，皮弁はほぼ
生着した．頤部の輪郭形成は良好である．
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図5 茎の臨床像．
a:皮膚筋茎．
b:筋茎．僧帽筋ごと浅頸動静脈を茎に含めている．
c:穿通枝茎．皮弁に付着した少量の僧帽筋の中枢側は浅頸動静脈の血管束となっている
（→）．
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図6 頭頂部の再建例．
項部の余剰皮膚は後に切除した．
図7 胸部の再建例．
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