H incision--method of choice for radical neck dissection.
To prevent skin necrosis, fistula formation and rupture of the carotid arteries after RND, vascularization of the skin of the neck has been considered. The neck vessels (in cadavers) were injected with coloured media and specimens of the skin were cleared (Spalteholz method). The arteries supplying the skin of the neck followed in general an obviously longitudinal course: one group of cutaneous arteries descending from the branches of the external carotid; another group ascending from the branches of the subclavian artery. The upper and lower groups of arteries joined approximately in the middle of the neck. The density of cutaneous arteries in the neck was much poorer than in the facial skin. On the basis of these anatomic data, an incision for RND has been proposed in the form of an H or three-quarter H, in which the transverse line of the incision follows the least vascularized skin region of the neck, without interrupting the great skin vessels. Incisions in the form of a Z or a double Y, OR McFee's incision, do not fulfil this requirement. The authors also report the results of wound healing after RND in 184 patients who were operated in the period fron 1968 to 1975 at the E. N. T. clinic of Ljubljana, where the H incision or one of its modifications was used.
D006801:Humans; D009333:Neck; D037981:Neck Dissection / Q000379:methods*; D012867:Skin / Q000098:blood supply; D014945:Wound Healing / Q000528:radiation effects