Transverse cervical vascular pedicle: It's extended use as ‘second-line’ recipient vessels in thoracic and upper arm reconstructions in addition to head-and-neck reconstructions

Srijana Muppireddy; Parvathi Ravula; Srikanth Rangachari; Najma Shaik; Sushma Maaturu

doi:10.4103/ijps.IJPS_9_18

Indian Journal of Plastic Surgery, Table of Contents

CC BY-NC-ND 4.0 · Indian J Plast Surg 2018; 51(02): 182-189
DOI: 10.4103/ijps.IJPS_9_18

Original Article

Association of Plastic Surgeons of India

Transverse cervical vascular pedicle: It's extended use as ‘second-line’ recipient vessels in thoracic and upper arm reconstructions in addition to head-and-neck reconstructions

Authors

Srijana Muppireddy

Department of Plastic and Reconstructive Surgery, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
Parvathi Ravula

Department of Plastic and Reconstructive Surgery, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
Srikanth Rangachari

Department of Plastic and Reconstructive Surgery, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
Najma Shaik

Department of Plastic and Reconstructive Surgery, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
Sushma Maaturu

Department of Plastic and Reconstructive Surgery, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India

Abstract

ABSTRACT

Background: Selection of recipient vessels is one of the key factors for a successful microvascular reconstruction. Non-availability of primary recipient vessels in the vicinity necessitates surgeon to approach a remote second-line vascular access. Transverse cervical vessels (TCV) have been described as second-line vascular access for head-and-neck reconstructions. Due to its location, their use can be extended to the proximal chest and upper arm reconstructions. Aim: The aim of the study is to analyse the reliability of TCV as second-line recipient vessels for the upper arm and chest reconstructions in addition to the head-and-neck reconstructions. Materials and Methods: During 2010–2017, 14 TCV were explored as the choice of second-line recipient pedicle for specific indications. Clinical experience with different reconstructions discussed. Results: Out of 14 transverse cervical arteries, 13 were of adequate size for anastomosis. About 12 successful reconstructions were performed involving the head and neck (7), proximal thorax (3) and upper arm (2) for indications such as scarring from different aetiology (8), previous free flaps (2) and sacrificed vessels (2). In one case, the arterial anastomosis was shifted to superior thyroid artery. All the chest and upper arm reconstructions needed a realignment of the pedicle without any kink. Transverse cervical vein (TCv) could be used only 5/14 times either alone or along with external jugular vein (EJV). In other cases, EJV alone was used. All the 12 flaps survived without any vascular event. Conclusions: Transverse cervical vessels are reliable second-line recipient vessels in the head and neck; in addition, they are of use in the upper arm and proximal chest defects.

KEY WORDS:

Chest and upper arm reconstructions - second-line recipient vessels - transverse cervical vessels

Full Text

References

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