THE USE OF THORACOACROMIAL ARTERIAL TRUNK AND CEPHALIC VEIN SYSTEM WITH DIFFERENT MODALITIES INCLUDING CHIMERIZATION OF FREE FLAP IN DIFFICULT SITUATIONS AS THE RECIPIENT VESSELS.

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. [ABSTRACT FROM AUTHOR]