ABSTRACT
This article details an algorithm we used for selection of recipient vessels in free
tissue transfer to the head and neck. Eighty-eight consecutive free flaps to the head
and neck were performed in 85 patients. The superior thyroid was the commonest recipient
artery used (61%). The facial artery, used in 14% of our cases, is the choice vessel
in instances where neck dissection is not performed. In these cases, we have to access
the neck separately for recipient vessels and it can be exposed easily via a short
(3-cm) incision. The superficial temporal artery (11%) is our choice vessel for patients
with previous neck dissection or radiotherapy as it is well outside the previous operative
or irradiated field. Other vessels such as the transverse cervical and end-to-side
anastomosis to the carotid artery were also used when appropriate. Recipient vein
selection depends primarily on the selected artery. Corresponding veins and large
branches of the internal jugular vein (IJV) in the vicinity of the selected artery
are preferred. When these are exhausted, the external jugular vein and end-to-side
anastomosis to the IJV are considered. We found this algorithm to be reliable in identifying
the appropriate vessels in all cases.
KEYWORDS
Recipient vessel - free flap - free tissue transfer - reliable - microsurgery
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Chin-Ho WongM.B.B.S. M.R.C.S. (Ed.) M.Med. (Surg.) F.A.M.S. (Plast. Surg.)
Department of Plastic Reconstructive and Aesthetic Surgery
Singapore General Hospital, Outram Road, Singapore 169608
Email: wchinho@hotmail.com
