Surgeon(s): ***
Assistant Surgeon(s): ***
Preoperative Diagnosis: ***
Postoperative Diagnosis: Same
Procedure(s): ***
Anesthesia: General
Implants: None
Specimen:***
Drains: None
Fluids: See anesthesia record
EBL: Minimal
Complications: None
Counts: Correct x2
Indications: ***
Findings: As expected
Procedure in Detail:
The patient was seen in the preoperative holding area with a H&P was updated, consents were verified, surgical site marked, and all questions and concerns related to the proposed procedure were discussed in detail. The patient was transferred to the operating room by the anesthesia team. The patient underwent general anesthesia with endotracheal intubation. Tegaderms were placed over the eyes. The patient was prepped and draped in the standard fashion for maxillofacial procedures. A time-out was performed and the procedure began.
A supraclavicular flap was planned based on the transverse cervical artery. An incision was made along the planned lines, starting from the supraclavicular region, extending towards the deltoid. The flap was elevated in a subfascial plane, preserving the vascular pedicle. Meticulous dissection was carried out to ensure the integrity of the transverse cervical artery and its perforators. Hemostasis was achieved with bipolar cautery. The flap was then transposed to the neck defect without tension. The donor site was closed primarily with minimal tension, and a drain was placed to prevent seroma formation. The flap was inset into the neck defect with interrupted 4-0 absorbable sutures for the deeper layers and 5-0 nylon for the skin. The flap was monitored for adequate perfusion, and there were no signs of venous congestion or arterial insufficiency.
The patient's face was then cleaned and the posterior pharynx was suctioned. An OG tube was used to suction out the contents of the stomach. Tegaderms were removed from the eyes. Dressings were placed. The patient was then transferred back to the care of the anesthesia team for extubation and recovery.