Abstract
Background The superficial circumflex iliac artery perforator (SCIP) flap is a versatile option
of free tissue transfer for small to large defects. In this study, we examine the
advantages of the SCIP flap, its cadaveric anatomy, and clinical subtypes.
Methods Ten cadavers were dissected and the corresponding pedicles of the SCIP and groin
flaps were identified. A retrospective review of 20 clinical cases of free SCIP flap
reconstruction was undertaken. The indication for reconstruction, flap dimensions,
and survival were analyzed. A systematic literature review was conducted including
articles that have previously reported the use of the SCIP flap.
Results The SCIP pedicle was present in all our cadaveric dissections. The starting point
of its pedicle ranged from 1.5 to 4.5 cm along the superficial circumflex iliac artery.
The median diameter of the perforator and its concomitant vein was 1mm (range 0.8–2 mm).
A cutaneous vein (1.3–2.3 mm) could be included in the flap if the concomitant vein
was too small. Twenty consecutive patients had free SCIP flaps between 2002 and 2018.
The indications were for finger defects (n = 8), thumb reconstruction (n = 1), lower limb compound fractures (n = 3), iatrogenic wounds (n = 2), upper limb large defects (n = 2), and scar contractures (n = 4). Flap dimensions ranged from 2 × 4 cm to 14 × 25cm, and the longest pedicle
was 8cm. All flaps survived. The systematic literature review identified 34 previous
reports using the SCIP flaps, most of these published by Asian units.
Conclusion The SCIP flap is useful for reconstruction throughout the body due to its ease of
dissection, thinness, adjustable pedicle length, and flap dimension ranging from tiny
to large, as well as the feasibility of raising a compound flap incorporating an adipofascial
or vascularized bone component if necessary.
This is a level of evidence therapeutic IV study.
Keywords anatomy - free tissue transfer - limb reconstruction
