Venous drainage of the lateral trapezius musculocutaneous island flap

The transverse cervical artery (TCA) and the transverse cervical vein (TCV) form the dominant vascular pedicle for the lateral trapezius musculocutaneous island flap. The experience of others described previously leaves little doubt as to the reliability of this flap. The anatomy of the TCA is such that we have encountered no difficulty in maintaining arterial flow through wide arcs of flap transfer. The TCV, on the other hand, is variable, and maintaining venous drainage may be difficult. After reviewing the available literature and finding little detailed guidance, we studied the anatomy of the TCV in nine patients undergoing surgery and in six fresh cadavers.