Abstract
Background The superficial circumflex iliac artery perforator flap (SCIP) is a thin, pliable,
and versatile flap used mainly for extremities and head and neck reconstruction. Different
planning methods have been described, but these are not yet standardized like in other
flaps. The aim of this study is to present a fast, effective, and reliable method
for SCIP flap planning using computed tomography angiography (CTA).
Patients and Methods Between October 2017 and September 2018, CTA was performed on 40 patients. Preoperative
planning of SCIP flaps based on the medial branch was performed analyzing CTA images.
The perforating sites of the medial branch on the deep (point D) and superficial fascia
(point S) were identified. Distances to those points, from the center of the umbilicus
in the “y-axis” and the midline perpendicularly in the “x-axis,” were measured. These
measurements were transferred to the patient's skin as a guide for dissection.
Results Eighty areas were studied identifying points D and S in CTA. Forty-three SCIP flaps
were performed using this planning method. In 100% of the flaps, points D and S matched
perfectly with handheld Doppler and surgical findings.
Conclusion Points D and S method for medial branch based SCIP planning with CTA is an easy to
learn, efficient, fast, and reliable technique for preoperative planning, allowing
a safe and predictable elevation of the flap.
Keywords
superficial circumflex iliac artery perforator flap - preoperative imaging - planning
method
