A retrograde island flap pedicled on the frontal branch of superficial temporal artery with additional vein anastomosis for reconstruction of peri-auricular defects

Abstract

Objective To investigate an effective method for solving the venous stasis in reverse peri-auricular flap pedicled on the frontal branch of superficial temporal artery(STA). Methods From October 2013 to May 2016, 5 patients with peri-orbital defects were reconstructed with a retrograde flap pedicled on the frontal branch of STA that incorporated additional venous anastomosis. The additional venous anastomosis was created between the parietal branch of STV (superficial temporal vein) and the middle temporal vein. The defects at donor sites were directly sutured. Results The size of flaps ranged from 2 cm×2 cm to 2 cm×8 cm. All flaps survived without venous stasis. Color and texture match of the flap were excellent .In three cases, flaps were thinned in secondary operation. During the follow-up period(6 months to 2 years, average of 12.4 months), flaps survived well on early period. Excellent color and tissue match with peri-orbital tissue were achieved on later stage. The scar at the donor site was inconspicuous. Conclusions Retrograde island flaps pedicled on the frontal branch of superficial temporal artery with vein anastomosis has the advantages of robust blood supply, good texture, and color match, and acceptable donor mobidity, while avoiding the venous stasis and flap necrosis. Key words: Surgical flaps; Frontal branch; Middle temporal vein; Venous stasis; Vein anastomosis