Infraclavicular free flap for head and neck reconstruction: Surgical description and early outcomes in 7 consecutive patients

Abstract

The primary purposes of this study were to introduce a novel fasciocutaneous free flap from the infraclavicular region based on the anterior perforator (AP) branch of the transverse cervical artery (TCA) and the retrograde external jugular vein (EJV), describe a reliable approach to flap design and elevation, and assess early clinical results. This was a prospective observational study of 7 consecutive cases of head and neck reconstruction using the infraclavicular free flap (ICFF) based on the AP of the TCA. Seven patients underwent ICFF reconstruction within a 6-month period. There was 100% flap survival in all cases at 14 days. Mean dimensions of the flap were 13.3 × 6.3 cm. The EJV drained the flap in all cases but the transverse cervical vein (TCV) was used in 1 case. The retrograde EJV was used in 5 cases to increase the venous pedicle length. No vein grafts were required. ICFF demonstrated similar outcomes compared to conventional fasciocutaneous free flaps. This flap has the potential for common application given its consistent anatomy and donor site advantages.