title: Infraclavicular free flap for head and neck reconstruction: surgical description and early outcomes in 7 consecutive patients.
abstract: BACKGROUND
  The primary purposes of this study were to introduce a novel fasciocutaneous free flap from the infraclavicular region based on the anterior perforator (AP) branch of the transverse cervical artery (TCA) and the retrograde external jugular vein (EJV), describe a reliable approach to flap design and elevation, and assess early clinical results.
  
  
  METHODS
  This was a prospective observational study of 7 consecutive cases of head and neck reconstruction using the infraclavicular free flap (ICFF) based on the AP of the TCA.
  
  
  RESULTS
  Seven patients underwent ICFF reconstruction within a 6-month period. There was 100% flap survival in all cases at 14 days. Mean dimensions of the flap were 13.3 × 6.3 cm. The EJV drained the flap in all cases but the transverse cervical vein (TCV) was used in 1 case. The retrograde EJV was used in 5 cases to increase the venous pedicle length. No vein grafts were required.
  
  
  CONCLUSIONS
  ICFF demonstrated similar outcomes compared to conventional fasciocutaneous free flaps. This flap has the potential for common application given its consistent anatomy and donor site advantages.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, London Health Sciences Center, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Yoo
authors.forename: Mathieu
authors.initials: M
authors.lastname: Belzile
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D002968:Clavicle; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000098:blood supply* / Q000637:transplantation*; D006084:Graft Rejection; D006085:Graft Survival; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D064827:Myocutaneous Flap / Q000098:blood supply / Q000637:transplantation*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D018570:Risk Assessment; D012494:Sampling Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: free flap; head and neck reconstruction; head and neck surgery; infraclavicular flap; supraclavicular flap