Pedicled Supraclavicular Flap Reconstruction Following Cervicofacial Necrotizing Fasciitis: A Case Report

Cervicofacial necrotizing fasciitis is a life-threatening surgical emergency associated with significant morbidity and mortality, requiring early diagnosis and aggressive multimodal management. Reconstruction of the resulting soft tissue defects represents an additional challenge, particularly in resource-limited settings where microsurgical infrastructure may not be available. We report the case of a 42-year-old man who developed cervicofacial necrotizing fasciitis secondary to an odontogenic infection. Management consisted of broad-spectrum antibiotic therapy, early surgical debridement, and negative pressure wound therapy as a bridge to reconstruction. Once infection was controlled and a viable granulation tissue bed was established, definitive reconstruction was performed using a pedicled supraclavicular fasciocutaneous flap. The procedure was completed without complications, with satisfactory flap integration, cervicofacial contour restoration, and minimal donor site morbidity documented at outpatient follow-up. The pedicled supraclavicular flap proved to be a safe, reliable, and technically reproducible reconstructive option in this postinfectious context, offering an intrinsic vascular supply independent of the compromised recipient bed, a wide arc of rotation, and excellent color and texture match to cervicofacial skin. Its applicability in settings without microsurgical resources further supports its role as a first-line reconstructive strategy. This case contributes to the limited evidence on supraclavicular flap reconstruction following cervicofacial necrotizing fasciitis and underscores the value of a sequential, protocol-driven approach in achieving favorable outcomes.