easy procedure for harvesting SCF

1. Harvesting supraclavicular flap
Jameel kifayatullah

2. Harvesting
• A preoperative angiography:to assess the presence and
integrity of the supraclavicular artery
• Marking of pedicle and skin paddle
The pedicle and the required dimensions of the flap skin
paddle are marked over the shoulder
First, mark the vascular flow using Doppler probe as far
as the middle portion of upper arm Second, draw the
flap outline with an elliptical shape within 5 cm of the
most distal Doppler point for flap viability.
• The flap is harvested in a zone defined by the edge of
the trapezius muscle posteriorly and a parallel line as
far as the deltoid muscle anteriorly.

3. Harvesting supraclavicular flap
• Skin incisions are made
• Flap is elevated in the subfascial plane remaining
superficial to the deltoid muscle
• Subfacial dissection done
• Perforators from deltoid cauterised
• Dissection safer till the perforator triangle
• We should ensure that the periosteum of the
medial end of the clavicle can be elevated and
included with the flap to provide additional
protection to vesicular pedicle

4. Flap Harvesting
• The flap is elevated cautiously in the perforator
triangle avoiding injury to the pedicle and
external jugular vein
• It is not necessary in this flap to identify and
isolate the vascular pedicle
• Once the sufficient length is reached, flap
elevation can be stopped
• Now the flap is taken to the recipient site by
tunneling under the sternocleidomastoid first and
then tunnel created lateral to the mandible

5. Flap Harvesting
• Tunnelled portion of the flap de-epithelialised
• Flap pedicled through the tunnel to the defect
• The flap is sutured to the remnant mucosa in
the oral cavity providing the skin flap inner
lining
• Primary closure of donor site after
undermining the skin over upper chest and
shoulder regions

7. Elevation of the supraclavicular artery flap (right side). a Vascular distribution
after flap elevation. b