Free Parascapular Flap Versus Free Superficial Circumflex Iliac Artery Perforator Flaps in Upper Limb Reconstruction.

Background: Upper limb tissue reconstruction poses significant challenges in achieving stable coverage and functional restoration. This study evaluated the efficacy of the free parascapular (PS) flap and the free superficial circumflex iliac artery perforator (SCIP) flap for upper extremity defect reconstruction, comparing their unique characteristics, aesthetic outcomes, and complications. Methods: A prospective clinical trial was conducted at a tertiary care hospital between February 2023 and February 2025, involving 20 patients who were divided into 2 groups: 10 received PS flaps (group A) and 10 received SCIP flaps (group B). Data on flap characteristics, operative time, donor-site morbidity, and aesthetic outcomes were collected and analyzed. Results: Group A flaps exhibited significantly greater flap lengths (18.4 ± 6.9 versus 9.2 ± 3.2 cm), pedicle lengths (8.6 ± 1.6 versus 5.64 ± 0.82 cm), and pedicle diameters (3.19 ± 1.02 versus 0.77 ± 0.2 mm) (P < 0.001). SCIP flaps offered logistical advantages, including supine positioning and consistent use of a 2-team approach (100% versus 50%, P = 0.03), with shorter operative times (334.3 ± 40.03 versus 413.6 ± 85.3 min, P = 0.01). Aesthetic outcomes were comparable. Complications were infrequent, with 1 total flap loss in group A and partial necrosis in group B. Conclusions: Both PS and SCIP flaps are reliable options for upper limb reconstruction. PS flaps offer larger pedicle dimensions, whereas SCIP flaps enable shorter operative times and concealed donor sites.