The submental island flap in head and neck reconstruction: A 10‐year experience examining application, oncologic safety, and role of comorbidity

BACKGROUND: We present our experience on reconstructive versatility and risk of nodal transfer with the submental island flap (SIF). We also examine the role of comorbidity as a predictor of complications. METHODS: Retrospective cohort study of patients undergoing SIF over 10‐year period. Comorbidity determined using Adult Comorbidity Evaluation 27 index (ACE‐27). Univariable/multivariable logistic regressions performed to determine association of these characteristics and rates of major complications. RESULTS: Fifty‐eight patients underwent SIF reconstruction, 27 (45%) patients had moderate/severe comorbidity, and 24 (41%) experienced major complication. Multivariable analysis identified ACE‐27 scores >2 predictive of major flap complications (OR: 17.38, 95% CI: 1.96–153.74, p = .01) and medical complications (OR: 5.8, 95% CI: 1.11–30.23, p = .037). There were no cases of pathologic nodal transfer. CONCLUSION: The SIF is a versatile flap and oncologically safe in carefully selected patients. The ACE‐27 index is strongly predictive of major postoperative complications. LEVEL OF EVIDENCE: 4