1：Experimental Design and Method Selection:

Augmented reality was used for superficial circumflex iliac artery perforator flap planning. Three-dimensional reconstruction images of the inguinal and lower abdomen vascular anatomy were performed from computed tomography angiography. Three-dimensional images were imported to a smartphone and an augmented reality app was used to superimpose them with the camera.

2：Sample Selection and Data Sources:

Patients who underwent upper or lower extremity microsurgical reconstruction with SCIP free flap were included.

3：List of Experimental Equipment and Materials:

A 64-detector row helical CT system (Brilliance 64; Philips, Amsterdam, Netherlands) with perforator protocol, maximum intensity projection, and 1-mm slice width. A 3-dimensional (3D) reconstruction image of inguinal and lower abdomen vascular anatomy was performed using a Multi Modality Advanced Vessel Analysis software (AVA) (Philips, Amsterdam, Netherlands).

4：Experimental Procedures and Operational Workflow:

The 3D image from CTA was reviewed online in a smartphone (Samsung Galaxy S7, Seoul, South Korea) and downloaded directly to the picture’s gallery. The 3D image was imported from the smartphone’s gallery to an AR app (Augmented Drawing, New Taipei City, Taiwan) to superimpose the image with the camera. Free hand drawings were performed guided through the smartphone screen, fixing the image to the landmarks (umbilicus, both ASIS and PS) identifying arteries and veins derived from the femoral vessels (superficial inferior epigastric (SIE), superficial branch of SCIP (s-SCIP), deep branch of SCIP (d-SICP)) and groin lymph nodes.

5：Data Analysis Methods:

Drawings performed with ARM-PS were correlated with handheld doppler and intraoperative findings. Flap harvest time was recorded and compared to a series of fifteen consecutive cases performed without ARM-PS, operated by the same team.