A fabricated chimeric SCIP flap with end-to-side anastomosis: A case report

Superficial circumflex iliac artery perforator flap (SCIP) is one of the most convenient flaps to cover distal extremity defects because it conceals the scar of the donor area well and can be raised as a thin or super-thin flap. In recent years, various chimeric SCIP flaps were reported, including the sartorius muscle, the lateral femoral cutaneous nerve, and the iliac bone. However, chimeric SCIP flap is sometimes difficult to be raised on one pedicle, because of the absence of communication between a skin branch and a branch to a chimeric tissue. We present a case in which end-side anastomosis of a sartorius muscle perforator to a SCIP flap pedicle is made to form a fabricated chimeric SCIP flap due to variation in the pedicle. This design aims to fill cavitary spaces and supply better perfusion for infection control.

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  • 1. Fox CM, Beem HM, Wiper J, Rozen WM, Wagels M, Leong JC. Muscle versus fasciocutaneous free flaps in heel reconstruction: systematic review and meta-analysis. Journal of reconstructive microsurgery. 2015;31(01):59-66.
  • 2. Goh TL, Park SW, Cho JY, Choi JW, Hong JP. The search for the ideal thin skin flap: superficial circumflex iliac artery perforator flap—a review of 210 cases. Plastic and Reconstructive Surgery. 2015;135(2):592-601.
  • 3. Iida T, Narushima M, Yoshimatsu H, Yamamoto T, Araki J, Koshima I. A free vascularised iliac bone flap based on superficial circumflex iliac perforators for head and neck reconstruction. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2013;66(11):1596-9.
  • 4. 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. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2016;69(9):1260-5.
  • 5. Buono P, Castus P, Dubois-Ferrière V, Rüegg EM, Uçkay I, Assal M, et al. Muscular versus non-muscular free flaps for soft tissue coverage of chronic tibial osteomyelitis. World Journal of Plastic Surgery. 2018;7(3):294.
  • 6. Yamamoto T, Yamamoto N, Kageyama T, Sakai H, Fuse Y, Tsuihiji K, et al. Definition of perforator flap: what does a "perforator" perforate? Global Health & Medicine. 2019;1(2):114-6.
  • 7. Flaps G, Strauch B, Yu H-L, Chen Z-W, Liebling R. Atlas of microvascular surgery: anatomy and operative approaches. New York: Thieme Medical Publishers. 1993:120-2.
  • 8. Yamamoto T, Yamamoto N, Kageyama T, Sakai H, Fuse Y, Tsuihiji K, et al. Supermicrosurgery for oncologic reconstructions. Global Health & Medicine. 2020:2019.01019.
  • 9. Kim JT, Kim YH, Ghanem AM. Perforator chimerism for the reconstruction of complex defects: a new chimeric free flap classification system. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2015;68(11):1556-67.
  • 10. Huang YC, Loh CYY, Lin CH, Lin YT, Hsu CC. Intraflap anastomoses for separated bone and cutaneous pedicle vascular anomaly in a chimeric medial femoral condyle flap. Microsurgery. 2017;37(8):954-5.