Clinical Article

Head and neck reconstruction using cephalic vein transposition in the vessel-depleted neck

  1. Vasileios Vasilakis B.Sc., M.B.B.S.1,
  2. Hasu D. L. Patel Ph.D., F.R.C.S.(Plast.)2,3,
  3. Hung-Chi Chen M.D., F.A.C.S.3,*

Article first published online: 15 JUN 2009

DOI: 10.1002/micr.20680

Issue

Microsurgery

Microsurgery

Volume 29, Issue 8, pages 598–602, November 2009

Additional Information

How to Cite

Vasilakis, V., Patel, H. D. L. and Chen, H.-C. (2009), Head and neck reconstruction using cephalic vein transposition in the vessel-depleted neck. Microsurgery, 29: 598–602. doi: 10.1002/micr.20680

Author Information

  1. 1

    Department of Surgery, St Bartholomew's and The Royal London Hospitals, Barts and The London NHS Trust, Whitechapel, London, E1 1BB, United Kingdom

  2. 2

    Department of Plastic and Reconstructive Surgery, St Bartholomew's and The Royal London Hospitals, Barts and The London NHS Trust, John Harrison House, London, E1 2DR, United Kingdom

  3. 3

    Department of Plastic and Reconstructive Surgery, E-DA Hospital, I-Shou University, Jiau-Shu Tsuen, Yan-Chau Shiang, Kaohsiung, Taiwan

*Department of Plastic and Reconstructive Surgery, E-DA Hospital, I-Shou University, No. 1 Yi-Da Road, Jiau-Shu Tsuen, Yan-Chau Shiang, Kaohsiung, Taiwan

Publication History

  1. Issue published online: 2 NOV 2009
  2. Article first published online: 15 JUN 2009
  3. Manuscript Accepted: 29 APR 2009
  4. Manuscript Received: 17 JAN 2009

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Abstract

In microvascular reconstructive surgery the patency of the recipient vessels is the key to successful outcome. In head and neck surgery there is often a lack of adequate recipient vessels as a result of chemoradiation therapy and ablative surgery. To overcome this it is crucial to identify vessels of adequate length and diameter outside the field of injury. We report our experience with cephalic vein transposition for drainage of seven free flaps—six intestinal and one osteocutaneous—for head and neck reconstruction. In five cases the cephalic vein was used during the free flap transfer and in two cases in salvage re-exploration surgery. All flaps survived completely. The anatomical course and location of the cephalic vein allow good patency and straightforward harvesting. Its vascular properties are predictive of reduced incidence of complications such as flap congestion and failure. We suggest that the cephalic vein offers a high venous flow drainage system for large free flaps and advocate its use in free intestinal transfer in the vessel-depleted neck as well as in re-exploration surgery. © 2009 Wiley-Liss, Inc. Microsurgery 2009.

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