title: Use of single saphenous interposition vein graft for primary arterial circuit and secondary recipient site in head and neck reconstruction: a case report.
abstract: BACKGROUND
  Autologous vein grafts are a valuable tool in microsurgical free tissue transfer. Interposition vein grafts offer the surgeon greater freedom when placing the free flap and choosing the recipient vessels, providing valuable options in case recipient vessels are not available for those patients with large wounds. Free flaps transferred to head and neck regions carry a higher risk of failure, which may be expected to increase more with the use of vein grafts.
  
  
  METHODS
  We present our case with the double use of a single vein graft for both primary arterial conduit in end-to-end fashion and secondary end-to-side recipient site in the microsurgical reconstruction of a complicated head and neck defect.
  
  
  RESULTS
  All these anastomoses and flaps survived perfectly, and the patient was discharged 14 days after the transfer of the second flap.
  
  
  CONCLUSIONS
  Although the anastomosis of 2 flaps to a single vein graft was successful in our case, it represents a higher risk option than different recipient vessels. We provide this alternative procedure in selected patients, as there is no other receipt vessel or recipient blood flow strong enough to supply more than 1 flap.
authors.affiliation: Department of Surgery, Division of Plastic and Reconstructive Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. kapich@kmu.edu.tw
authors.forename: Kao-Ping
authors.initials: KP
authors.lastname: Chang
authors.forename: Hsiao-Chen
authors.initials: HC
authors.lastname: Lee
authors.forename: Chung-Sheng
authors.initials: CS
authors.lastname: Lai
authors.forename: Sin-Daw
authors.initials: SD
authors.lastname: Lin
mesh_terms: D000328:Adult; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012501:Saphenous Vein / Q000637:transplantation*; D013524:Surgical Flaps / Q000098:blood supply*