Supraclavicular Artery Island Flap: Critical Appraisal and Comparison to Alternate Reconstruction

Objectives/Hypothesis The supraclavicular artery island (SAI) flap may be a good option for selected head and neck reconstruction due to its reliability, ease of harvest, and favorable color match. The objective of this study was to examine the rates of complications for the SAI flap in head and neck oncologic reconstruction, with examination of risk factors and comparisons to alternative flaps often considered the gold‐standard soft‐tissue flaps for head and neck reconstruction: the pectoralis myocutaneous (PMC), radial forearm free flap (RFFF), and anterolateral thigh (ALT) flaps. Study Design Retrospective cohort study. Methods Consecutive SAI flaps were compared to PMC, RFFF, and ALT flaps (non‐SAI flap group), all performed by the senior author from 2010 to 2018. The non‐SAI flaps were included if an SAI flap could have been performed as an alternate flap. The groups were compared based on demographics, flap dimensions, site of reconstruction, operating time, total hospital stay, total hospital costs, and complications. Results One hundred seven SAI flaps and 194 non‐SAI flaps were identified. SAI flaps were used less commonly than non‐SAI flaps for mucosal defects (P