ZOR DURUMLARDA ALICI DAMAR OLARAK SERBEST FLEP KİMERİZASYONUNU İÇEREN FARKLI MODALİTELERLE BİRLİKTE TORAKOAKROMİAL ARTERYEL GÖVDE VE SEFALİK VEN SİSTEMİNİN KULLANIMI

Abstract

Objective
 We aimed to remind surgeons of the presence of the
 thoracoacromial arterial trunk and cephalic vein (TATCV)
 for a comfortable and reliable free flap transfer
 to the head, arm, and trunk, in case the mainstream recipient vessels of these regions pose some inconveniences
 due to previous surgery, radiotherapy, or
 trauma.
 Material and Methods
 Eight cases of trauma or tumor involving the head and
 neck or upper extremity, treated with free tissue transfer
 in which this vascular system was used with different
 modalities, were reviewed retrospectively.
 Results
 This vascular system proved to be reliable in all cases.
 It enabled chimerization with the pectoral flap. It was
 used in six patients for head and neck reconstructions
 and in two upper extremity restrorations. Switching
 the anastomoses to TAT-CV site and cephalic vein
 transposition were found to be rapid and reliable methods
 to rescue a flap with compromised circulation.
 Discussion
 Although anatomically well known by many reconstructive
 surgeons, its ease of dissection, consistency,
 supply of branches of differing caliber, and strategic
 location is not adequately appreciated. Moreover, in
 cases of pectoralis major flap transfer in which additional
 tissue is required, this vascular system is already
 there to receive it.