Vascularized Genitofemoral Nerve Flap Based on the Deep Branch of the Superficial Circumflex Iliac Artery

We read with great interest the article “A New Planning Method to Easily Harvest the Superficial Circumflex IliacArtery Perforator Flap” by Pereira et al.[1] Superficial circumflex iliac artery perforator (SCIP) flap is a useful option for various cases, and allows various tissue reconstructions with chimeric portions.[2] [3] [4] [5] The lateral femoral cutaneous nerve (LFCN) is the most commonly used nerve flap based on the SCIP deep branch. However, harvest of a LFCN flap is sometimes difficult. To address this challenge, the genitofemoral nerve (GFN) can be an option for SCIP-based nerve flap ([Fig. 1]).

SCIP flap is a perforator flap whose perforator is the branch of superficial circumflex iliac artery. Superficial circumflex iliac artery has superficial and deep branches, and they nourish SCIP flap. Using SCIP flap has many benefits. For example, it has long vascular pedicle, and the donor site is concealable. It can be harvested as a thin flap less invasively; therefore, SCIP flap is useful for various sites: arms, legs, neck, and penis.[2] [4] [5]

LFCN is a branch of the lumbar plexus. This nerve enters the thigh by passing through or in the caudal part of the inguinal ligament from just medial to the anterior superior iliac spine. It is commonly used nerve flap based on the SCIP deep branch, but harvest of a LFCN flap is sometimes difficult. GFN is a branch of femoral nerve that distributes the medial surface of thigh. We propose this nerve flap based on the proximal deep branch of the superficial circumflex iliac artery.

Although further studies are required to elucidate precise anatomy and usefulness of GFN with regard to the SCIP deep branch, SCIP-based GFN can be an option for nerve reconstructions, allowing better nerve regeneration with concealable donor site scar even when LFCN cannot be harvested based on SCIP.

Fig. 1 Anatomy of SCIA and relationship to LFCN and GFN. GFN, genitofemoral nerve; LFCN, lateral femoral cutaneous nerve; SCIAd, deep branch of superficial circumflex iliac artery; SCIAs, superficial branch of superficial circumflex iliac artery.

Publication History

Received: 19 June 2020

Accepted: 25 August 2020

Article published online:
14 October 2020

• References

• 1 Pereira N, Parada L, Kufeke M, Troncoso E, Roa R. A new planning method to easily harvest the superficial circumflex iliac artery perforator flap. J Reconstr Microsurg 2020; 36 (03) 165-170
• 2 Yamamoto T, Saito T, Ishiura R, Iida T. Quadruple-component superficial circumflex iliac artery perforator (SCIP) flap: a chimeric SCIP flap for complex ankle reconstruction of an exposed artificial joint after total ankle arthroplasty. J Plast Reconstr Aesthet Surg 2016; 69 (09) 1260-1265
• 3 Yamamoto T. Onco-reconstructive supermicrosurgery. Eur J Surg Oncol 2019; 45 (07) 1146-1151
• 4 Yamamoto T, Yamamoto N, Kageyama T. et al. Supermicrosurgery for oncologic reconstructions. Global Health & Medicine. 2020; 2 (01) 18-23
• 5 Yamamoto T, Yoshimatsu H, Yamamoto N. Complete lymph flow reconstruction: a free vascularized lymph node true perforator flap transfer with efferent lymphaticolymphatic anastomosis. J Plast Reconstr Aesthet Surg 2016; 69 (09) 1227-1233