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Anatomic study on the transverse cervical vessels perforators in the lateral triangle of the neck and harvest of a new flap: the free supraclavicular transverse cervical artery perforator flap

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Abstract

Background

Vessels in the supraclavicular area and their contribution to skin vascularization have always been studied for flaps planning in head and neck reconstruction and many pedicled flaps have been described based on those vessels. Little has been written instead about the vascularization of the supraclavicular skin itself for the use as a free flap. The purpose of this anatomical study was to assess the vascularization of the supraclavicular skin and the possibility of finding an adequate pedicle to harvest it as a free flap in order to close the donor site directly.

Methods

A total of 25 cadavers, 10 formalin fixed and 15 fresh, have been studied in cooperation with the Division for Clinical–Functional Anatomy, Department of Anatomy, Histology and Embryology, Innsbruck Medical University, Innsbruck, Austria and the Laboratoire d’Anatomie, Universiteé R. Descartes, Paris, France.

Results

The supraclavicular skin was nourished by perforators coming from the transverse cervical artery and constantly present in an average number of four. Venous drainage was accomplished through the superficial cervical vein, and not through the venae comitantes of the transverse cervical artery.

Conclusions

Based on the results of this investigation, a free supraclavicular transverse cervical artery perforator (STCAP) flap seems to be feasible pedicled on perforators from the transverse cervical artery and drained by the superficial cervical vein. Due to its thickness and skin texture, it can be indicated for facial and intraoral defects, with the limitations of a relatively short pedicle. Primary closure of the donor site can be accomplished concealing the scar in the neck crease.

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Authors and Affiliations

  1. Cattedra di Chirurgia Plastica e Ricostruttiva, Dipartimento di Discipline Chirurgiche ed Oncologiche, Università degli Studi di Palermo, Via del Vespro, 129-90127, Palermo, Italy

    Adriana Cordova, Salvatore D’Arpa, Roberto Pirrello & Francesco Moschella

  2. Laboratoire d’Anatomie, Université R. Descartes, Rue de Saint Peres, 75006, Paris, France

    Adriana Cordova, Roberto Pirrello & Francesco Moschella

  3. Department of Plastic and Reconstructive Surgery, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria

    Johannes Jeschke

  4. Division for Clinical-Functional Anatomy, Department of Anatomy, Histology and Embryology, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria

    Erich Brenner

  5. C.da Bagliuso, sn, 90049, Terrasini, PA, Italy

    Adriana Cordova

Authors
  1. Adriana Cordova
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  2. Salvatore D’Arpa
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  3. Roberto Pirrello
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  4. Erich Brenner
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  5. Johannes Jeschke
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  6. Francesco Moschella
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Correspondence to Adriana Cordova.

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Cordova, A., D’Arpa, S., Pirrello, R. et al. Anatomic study on the transverse cervical vessels perforators in the lateral triangle of the neck and harvest of a new flap: the free supraclavicular transverse cervical artery perforator flap. Surg Radiol Anat 31, 93–100 (2009). https://doi.org/10.1007/s00276-008-0410-x

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  • DOI: https://doi.org/10.1007/s00276-008-0410-x

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