title: Surgical approaches to recipient vessels of the head and neck for microvascular free tissue transfer in dogs.
abstract: 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.
  
  
  METHODS
  Experimental anatomic study.
  
  
  METHODS
  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 and thus its use could not be recommended. The approach to the vessels in the cervical region was easily performed. Because of the large size of the external jugular vein and the common carotid artery, end-to-side anastomosis of the donor to recipient vessels is necessary. The large superficial cervical vessels were easily accessed by a lateral shoulder approach.
  
  
  CONCLUSIONS
  Surgical approaches to potential recipient vessels of the head and neck were consistently achieved and provided relatively easy access to the vessels. Clinical Relevance- The surgical approaches described in this report can be used to isolate arteries and veins of the head and neck that are >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.
authors.affiliation: Michigan Veterinary Specialists, and the College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA. ddegner@comcast.net
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Degner
authors.forename: Richard
authors.initials: R
authors.lastname: Walshaw
authors.forename: J David
authors.initials: JD
authors.lastname: Fowler
authors.forename: Otto I
authors.initials: OI
authors.lastname: Lanz
authors.forename: Peter
authors.initials: P
authors.lastname: Ocello
authors.forename: Jackie
authors.initials: J
authors.lastname: Maier
authors.forename: Loren
authors.initials: L
authors.lastname: Blaezer
authors.forename: Rick J
authors.initials: RJ
authors.lastname: Smith
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods / Q000662:veterinary*; D000818:Animals; D001158:Arteries / Q000601:surgery*; D004285:Dogs / Q000601:surgery*; D006257:Head / Q000601:surgery*; D009333:Neck / Q000601:surgery*; D013524:Surgical Flaps / Q000662:veterinary*; D014656:Vascular Surgical Procedures / Q000379:methods; D014680:Veins / Q000601:surgery*