Flaps pedicled on the superficial temporal artery and vein in facial reconstruction: A versatile option with a venous pitfall

• Published in: Journal of plastic surgery and hand surgery Vol. 45; no. 4-5; pp. 178 - 187
• Main Authors: Ausen, Kjersti, Pavlovic, Ivan
• Format: Journal Article
• Language: English
• Published: Sweden Informa Healthcare 01.09.2011; Taylor & Francis
• Subjects: Face - surgery; facial reconstruction; heparin; Humans; Hyperemia - etiology; pedicled flaps; Postoperative Complications; Reconstructive Surgical Procedures - methods; Salvage Therapy; Scalp - blood supply; Superficial temporal artery; Surgical Flaps; Temporal Arteries; Veins; venous congestion; venous stasis
• ISSN: 2000-656X; 2000-6764
• DOI: 10.3109/2000656X.2011.582373

Abstract Flaps pedicled on the superficial temporal vessels are versatile in reconstruction of the face and scalp. Various tissues can be harvested and flexible pivot points and long pedicles allow for them to reach the entire face. Colour and texture match is good, and morbidity at the donor site is usually minimal. However, venous anatomy of the temporal area is unpredictable, and this anatomical point has not been clearly reported in papers and anatomical atlases. One must be aware of the risk of venous inconsistency and plan the pedicle accordingly. In the absence of a suitable vein, drainage can be provided through concomitant veins in a sufficient cuff of fascia around the pedicle's artery. We have reviewed published reports about reconstructive possibilities provided by temporal flaps, for descriptions of the venous drainage of the temporal area, and for salvage procedures in case of venous stasis. We present our own salvage procedure, the "modified poor man's leech", in which continuous venous oozing from a de-epithelialised area is maintained by topical heparin and low molecular weight heparin injections and may save a congested flap.