Flaps pedicled on the superficial temporal artery and vein in facial reconstruction: a versatile option with a venous pitfall
Review published in Journal of plastic surgery and hand surgery (2011)
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.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Flaps pedicled on the superficial temporal vessels are versatile in reconstruction of the face and scalp.
Why This Matters for Hirudotherapy
This article reviews the use of superficial temporal vessel flaps in facial and scalp reconstruction, noting that venous anatomy of the temporal area is unpredictable and may lead to congestion. The authors present a salvage procedure they call the 'modified poor man's leech,' in which continuous venous oozing from a de-epithelialised area is maintained using topical heparin and low molecular weight heparin injections to relieve a congested flap. The relevance to hirudotherapy is limited to the authors' metaphorical naming of the technique, which references leeches; the abstract makes no claims about medicinal leeches as standard treatment, nor does it state that the heparin-based method mimics leech effects. No actual leech therapy or leech secretome components are evaluated.
Citation
Flaps pedicled on the superficial temporal artery and vein in facial reconstruction: a versatile option with a venous pitfall
Ausen K et al. · Journal of plastic surgery and hand surgery, 2011
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