Vai trò mặt phẳng cân nông trong kỹ thuật bóc vạt SCIP mỏng: Nghiên cứu giải phẫu hình ảnh cắt lớp và lâm sàng

Abstract

The superficial circumflex iliac artery perforator (SCIP) flap is a thin flap suitable for hand reconstruction. The superficial fascia provides an optimal plane for thin flap elevation. However, whether the thickness of the superficial fat layer measured on CTA accurately reflects the actual thickness of the SCIP flap after elevation on the superficial fascial plane has not yet been fully investigated. Computed tomography angiography (CTA) assists in preoperative assessment of superficial fat thickness. This prospective study included 63 patients with 64 free SCIP flaps, aiming to evaluate the correlation between superficial fat thickness on CTA and actual flap thickness after elevation on the superficial fascia. Superficial fat thickness at the perforators of the superficial and deep branches was 3.5 ± 1.7 mm and 2.8 ± 1.0 mm, respectively, showing positive correlations with corresponding flap thickness (r = 0.58 and r = 0.64, Pearson). Eleven flaps required additional microsurgical thinning, associated with higher BMI (p = 0.02). Complete flap survival was 96.9%. These results demonstrate that superficial fat thickness on CTA correlates with actual flap thickness after elevation, supporting preoperative prediction of flap thickness and planning for additional thinning when needed.