Knacks and pitfalls for superficial circumflex iliac artery perforator flap.

PURPOSE: To review the utility of the Superficial Circumflex Iliac Artery Perforator (SCIP) flap for a wide range of defect reconstructions, emphasizing the groin's vascular anatomy, relevant anatomical variations, and recent advancements overcoming traditional groin flap limitations.

METHODS

Based on a literature review, anatomical knowledge, and clinical experience, this article summarizes the variations of the superficial circumflex iliac artery (SCIA), surgical techniques for SCIP flap harvesting, and the role of preoperative color Doppler ultrasound mapping for safe and efficient flap elevation.

RESULTS

The SCIA displays significant anatomical variations, necessitating thorough preoperative assessment for successful flap harvest. The perforator flap concept and supermicrosurgery have addressed the challenges of the traditional groin flap's short, small pedicle, making the SCIP flap a more reliable option. The SCIP flap offers remarkable versatility by potentially including multiple tissues-skin, fat, lymphatic vessels, lymph nodes, deep fascia, sartorius muscle, lateral femoral cutaneous nerve, and iliac bone-allowing its use as a chimeric flap for a broad spectrum of defects, ranging from simple to complex.

CONCLUSIONS

With a comprehensive understanding of groin vascular anatomy and appropriate preoperative evaluation, including color Doppler ultrasound, the SCIP flap is a reliable and highly versatile reconstructive tool. Its ability to incorporate various tissues and minimal donor site morbidity, with scars concealable under clothing, make it an excellent choice for various reconstructive challenges.