The thoracoacromial/cephalic vascular system for microvascular anastomoses in the vessel-depleted neck.

OBJECTIVE To review our experience with use of the thoracoacromial/cephalic (TAC) system in the free flap reconstruction of complicated head and neck defects. DESIGN Case series. SETTING Tertiary care referral center. POPULATION A consecutive sample of 11 patients requiring free flap reconstruction of head and neck defects using the TAC system for microvascular anastomoses was identified by medical chart review. INTERVENTION Free flap reconstruction of complicated defects of the head and neck using the TAC vascular system for microvascular anastomoses. MAIN OUTCOME MEASURES Free flap survival and microvascular thrombosis. RESULTS Of 11 patients using TAC anastomoses, all had complete survival of free flaps. No complications related to anastomotic failure were identified. CONCLUSIONS The TAC system provides a reliable source of undisturbed vessels when cervical vessels are unusable or absent.