Cephalic vein: Saviour in the microsurgical reconstruction of breast and head and neck cancers
A 34-year-old female underwent modified radical mastectomy and primary reconstruction with free MSTRAM flap. On exposing the internal mammary vessel, there were enlarged lymph nodes over the vessels []. Hence, the DIEA and one of the venae comitantes were anastomosed to the acromiothoracic artery and vein, respectively. The acromiothoracic vein was preserved and was of good caliber in this patient. Though the venous drainage was found to be adequate initially; there was diffuse congestion of the flap after 6 h post-surgery. On re-exploration, both the anastomosis was found to be patent with normal flow across the anastomosis. The other venae comitantes was distended and tense compared with the superficial veins. Hence, it was diagnosed that the venous drainage is insufficient and the other venae comitantes was anastomosed to the cephalic vein. The venous congestion was relieved and the flap settled well.