Poster Presentation NZ Association of Plastic Surgeons & NZ Society for Surgery of the Hand

Ultra-thin pedicle axial SCIP flap in finger reconstruction surgery – A case series (1494)

Samitha Prasad Iddagoda Hewage Don 1 , Dammika Dissanayake 2
  1. Plastic and Reconstructive Surgery Department, Waikato DHB, Hamilton, Waikato, New Zealand
  2. Plastic and Reconstructive Surgery Department, National Hospital Sri Lanka, Colombo, Sri Lanka


Superficial Circumflex Iliac Artery Perforator (SCIP) flap is well known for hand reconstruction but limited use in finger resurfacing surgery. We describe a thinly harvested axial SCIP flap for finger reconstruction in this short series.


Three patients were selected in whom other reconstructive options were limited due to the nature of the injury/infection and unavailability of local flaps

  • 10 year old boy with electrical burn to right hand with exposed extensor hood in his little finger with multiple ipsilateral deep burns
  • 26year old male with Left hand runover injury with middle finger degloving exposing bones and amputations of ring and little.
  • 62year old gentlemen with DM and smoking with skin loss over Left Little finger extensor zone 1 to 3 after abscess drainage.

Operative surgery – This flap was based on SCIPs around ASIS; usually a dominant perforator on the Sartorius attachment; which were marked by the hand held Doppler preoperatively. Exploratory incision was made 1cm bellow ASIS and perforator size, quality and branching patterns were delineated. Appropriate size flap was then marked out based on one lateral ascending subcutaneous branches. Anterograde flap dissection was done, under 3.5x loupe magnification, including only the identified vessel and its subdermal vascular plexus, thus harvesting an ultra-thin axial pattern flap containing only skin and subdermal fat.

Flap was inserted to the finger defect edge to edge without any difficulty. Flap separation was done in 3weeks but delaying was done in one.


All patients had excellent flap outcome though one got distal flap congestion which was managed with adjusting the hand position. De-bulking wasn’t needed and groin incision healed nicely. Finger stiffness was seen in adult patients needing subsequent hand therapy.


Ultra-thin groin flap is a successful flap in finger resurfacing, yet a larger sample size is needed.