The Supraclavicular Artery Island Flap: A Practical Approach for Reconstruction of Extensive Cervicofacial Defects Following Giant Cavernous Hemangioma Resection

Objective: To demonstrate the utility of the supraclavicular artery island flap (SCAIF) as a viablealternative to free tissue transfer for reconstruction of large cervicofacial defects. Methods:Design: Case ReportSetting: Tertiary National University HospitalPatient: One Results: A 43-year-old woman with a giant cavernous hemangioma measuring 21.43 x 9.91 x 20.75cm underwent tumor resection and immediate reconstruction using SCAIF. Following preoperative embolization and complete tumor excision, an 11 x 15cm cervicofacial defect was successfully reconstructed using SCAIF. The patient experienced post-operative complications including multiple wound dehiscences and hypertrophic scar formation but achieved significant functional and aesthetic improvement. At three months follow up, the patient reported cessation of bleeding episodes, improved feeding capacity, and enhanced quality of life despite persistent tracheostomy dependence. Plans for secondary surgery include scar revision, commissuroplasty, and intralesional steroid injections. Conclusion: The supraclavicular artery island flap presents a practical, cost-effective alternative to free tissue transfer for extensive cervicofacial reconstruction, particularly in resource-limited environments or in patients where free tissue transfer is contraindicated. Advantages include good color match, wide arc of rotation, and ease of harvest. Despite potential complications, it offers excellent functional and aesthetic outcomes with acceptable donor site morbidity.