Arterializing the Venous System in a SCIP Flap—Insights Into Tissue Perfusion Biomechanics: A Case Report

This case report presents a novel observation on tissue perfusion biomechanics achieved through arterializing the deep venous system in a superficial circumflex iliac artery perforator (SCIP) flap. An 89-year-old male with a cutaneous squamous cell carcinoma overlying the mandible underwent SCIP flap reconstruction. The flap was 5 mm thick and measured 8 cm × 7 cm. Due to pedicle damage, the venae comitantes served as the inflow system, anastomosed to a facial artery branch, while the superficial circumflex iliac vein served as the outflow system. The flap initially showed venous congestion but resolved without intervention, healing with an acceptable color match and contour over a six-month follow-up. This novel technique suggests that venous systems can be repurposed to support tissue perfusion effectively, offering new insights into tissue perfusion biomechanics. The broader implications of this approach include expanding our understanding of tissue perfusion mechanisms, which could lead to broader applications in reconstructive surgery. Ultimately, this method may enable the use of donor sites that do not rely on intrinsic arterial systems, potentially increasing the versatility of flap reconstruction techniques.