Venous Drainage Pattern of Superficial Circumflex Iliac Artery Perforator (SCIP) Flap: Implications for Surgical Planning and Outcomes

Abstract

Background: – The superficial circumflex iliac artery (SCIA) perforator (SCIP) flap is widely used in reconstructive surgery due to its low donor site morbidity and favorable scar concealment. This research aims to describe the venous anatomy and drainage of the SCIP flap to enhance preoperative planning and improve surgical outcomes. Methods: – This investigation included both cadaveric and clinical studies. The cadaveric study involved 17 fresh cadavers, excluding those with prior groin surgery. Heated saline contrast solution was injected into the femoral vein to facilitate the visualization of the venous system of the SCIP flap. The clinical study involved 64 patients who underwent groin flap harvesting from September 2019 to February 2021. Preoperative venous patterns were assessed using computed tomography angiography and duplex ultrasound, while intraoperative findings were recorded by a senior surgeon. Results: – In the cadaveric study, the SCIV and accompanying venae comitantes (VC) were observed in 22 out of 30 specimens. The SCIV was classified into two types according to its connection with the VC. In the present clinical study, three perioperative complications were encountered, namely two total flap losses and one minor hematoma, with no evidence of venous congestion. Conclusions: – The venous drainage patterns of the groin flap can be classified into distinct types, aiding surgeons in the planning and design of SCIP flaps to enhance surgical precision. Understanding the reciprocal dominance between SCIA and superficial inferior epigastric artery systems enhances the reliability of groin flaps, making them a versatile choice for reconstructive surgery. CLINICAL QUESTION / LEVEL OF EVIDENCE: Therapeutic, III