Surgical approaches to recipient vessels of the head and neck for microvascular free tissue transfer in dogs

OBJECTIVE: To develop and evaluate surgical approaches to the arteries and veins of the head and neck for use as potential recipient vessels for free tissue transfer. STUDY DESIGN: Experimental anatomic study. SAMPLE POPULATION: Eleven canine cadavers; 2 preserved cadavers and 9 fresh cadavers. METHODS: The head and neck of one preserved cadaver injected with pigmented silicone/barium, through the common carotid artery and external jugular vein, was cut in 1 cm sagittal sections and cross-sections. These tissue sections were used to identify the location of recipient vessels >1 mm that could be used as recipient vessels for free tissue transfer. The other preserved cadaver was used to develop surgical approaches to these vessels. Three board certified surgeons evaluated the written descriptions and illustrations of the approaches using fresh cadavers. Modifications to the surgical approaches were made based on recommendations from these surgeons. RESULTS: Seven approaches were developed to isolate recipient vessels of the head and neck region. The infraorbital, temporal, and sublingual approaches were easily performed and provided excellent access to the vessels in the region. The approach to the caudal auricular vessels was found to be more difficult but modification of the approach resolved this problem. Access to the facial artery was difficult; it was consistently 1 mm in diameter. These vessels are suitable for use as recipient vessels for free tissue transfer for reconstruction of complex wounds of the head and neck.