Clinical and Anatomical Study of Superficial Cervical Artery Flaps: Retrospective Study of Reconstructions with 41 Flaps and the Feasibility of Harvesting Them as Perforator Flaps

Abstract

The superficial cervical artery musculocutaneous flap was first reported by Nakajima and Fujino in 1984; the present authors developed it for use as a skin flap in 1990, and in 1993, they succeeded in harvesting it as a free flap. Since 1986, they have harvested 41 superficial cervical artery flaps of various types from 32 patients to reconstruct head and neck scar contractures and intractable ulcers. In a retrospective clinical study, the authors classified these 41 flaps into three types according to their pedicles: musculocutaneous pedicled flaps (n = 5); muscle pedicled flaps (n = 14), and vascular pedicled flaps (n = 22). In an anatomical study, they harvested 10 flaps from five preserved cadavers and took microangiograms of the trapezius muscle and dorsal skin to identify the distribution of the superficial cervical artery. Thirty-six flaps survived completely, and both the aesthetic and functional results were good. Among the other five flaps, partial necrosis was observed in four and complete necrosis was seen in one. Among the 36 surviving flaps, 23 were more than 30 cm long. The authors fully confirmed from their clinical and anatomical studies that the superficial cervical artery flap is useful for reconstruction of the head and neck regions. In each flap, the superficial cervical artery was found to be a "transverse cervical perforator" or "trapezius perforator" and was large enough to be used as a vascular pedicled flap, suggesting that it can be elevated as a "perforator flap."