Safety and Utility of Superficial Circumflex Iliac Perforator versus Superficial Circumflex Iliac Artery Flaps in Pediatric Reconstructive Surgery

Noelle Garbaccio; Dorien I. Schonebaum; Jade E. Smith; Justin J. Cordero; Lacey Foster; Morvarid Mehdizadeh; Arriyan S. Dowlatshahi; Samuel J. Lin

doi:10.1055/a-2717-4139

Journal of Reconstructive Microsurgery, Table of Contents

J Reconstr Microsurg
DOI: 10.1055/a-2717-4139

Original Article

Safety and Utility of Superficial Circumflex Iliac Perforator versus Superficial Circumflex Iliac Artery Flaps in Pediatric Reconstructive Surgery

Authors

Noelle Garbaccio^‡

¹Department of Plastic and Reconstructive Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States

²Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, United States
Dorien I. Schonebaum^‡

¹Department of Plastic and Reconstructive Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States

³Department of Plastic and Reconstructive Surgery, Amsterdam UMC, Amsterdam, The Netherlands
Jade E. Smith

¹Department of Plastic and Reconstructive Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
Justin J. Cordero

¹Department of Plastic and Reconstructive Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
Lacey Foster

¹Department of Plastic and Reconstructive Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
Morvarid Mehdizadeh

¹Department of Plastic and Reconstructive Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
Arriyan S. Dowlatshahi

¹Department of Plastic and Reconstructive Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
Samuel J. Lin

¹Department of Plastic and Reconstructive Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States

Abstract

Background

The superficial circumflex iliac perforator flap (SCIP-f) is a thinned adaptation of the superficial circumflex iliac artery flap (SCIA-f) that may have superior use flexibility, smaller scar burden, and lesser need for revision, advantages well-suited to pediatric patients. Despite documented success in adults, the safety and utility of SCIP and SCIA-f are underexplored in pediatric populations.

Methods

A systematic review of MEDLINE, Web of Science, Embase, and Cochrane databases identified 93 articles reporting SCIP/SCIA-f outcomes in patients ≤ 17 years of age. Patient demographics, clinical characteristics, and postoperative outcomes were collected. Cohorts were stratified by SCIP/SCIA and age group. Mann–Whitney U tests compared cohort outcomes.

Results

Thirty-one studies were included, constituting 107 SCIA-f and 57 SCIP-f, with ages 10 weeks to 17 years. Most cases were congenital or traumatic defects in upper/lower extremities. Compared with SCIA-f, SCIP-f demonstrated significantly lower rates of all-cause complications, total flap loss, major and minor complications, and debulking (p < 0.05). All-cause complication rates were also significantly lower across age groups (p < 0.001).

Conclusion

This meta-analysis demonstrates favorable efficacy and safety of SCIP-f in children with congenital and traumatic defects, especially of the extremities. SCIP-f may be considered a reliable option for pediatric reconstruction. Additionally, fewer subsequent procedures for contouring may be required.

Keywords

superficial circumflex iliac - SCIA - SCIP - pediatric reconstruction - groin - LMIC - extremity

Full Text

References

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