The use of a superficial circumflex iliac artery perforator flap obtained by a proximal to distal freestyle technique for the reconstruction of limb defects.

Background: The superficial circumflex iliac artery (SCIA) perforator flap needs meticulous dissection because of anatomical variations. These variations of the SCIA allow the flap to be used in different parts of the body for different purposes. The aim of this study is to evaluate the versatility of using the SCIP flap in the reconstruction of composite defects in the upper and lower extremities. Methods: Between 2017 and 2021, twenty-nine patients who had undergone reconstruction with SCIP flap and whose defects were located in the lower and upper extremities were included. Results: The location of the defect was in the lower extremity in nine of the patients, and the upper extremity in twenty of the patients. The flap was raised from the superficial branch in thirteen of the patients, the deep branch in five of the patients, and the main trunk in eleven of the patients. The chimeric flap concept included both fascia and bone tissue other than the skin. Complications occurred in seven of the patients. Bone tissue loss occurred in one patient due to a perforator kink. Partial necrosis was encountered in four flaps, with two flaps failing, so the survival rate was 93.1%. Conclusions: Although the SCIA has numerous anatomical variations, bringing certain difficulties, these variations can become an advantage when the anatomy of this region and microsurgical techniques are mastered. With the proximal to distal freestyle technique, the branch with sufficient calibration and pulsation can be safely selected from the superficial branch or deep branch. Level of evidence: Level IV, Therapeutic [ABSTRACT FROM AUTHOR]