The Surgical Anatomy of the Supraclavicular Lymph Node Flap: A Basis for the Free Vascularized Lymph Node Transfer

Background: Vascularized lymph node transfer is an effective surgical method in reducing lymphedema. This study provides the first detailed description of the surgical anatomy of the supraclavicular lymph node flap in regard to pedicle length, pedicle diameter, and the number of lymph nodes and their exact location inside the flap. Methods: Bilateral supraclavicular dissections of nine fresh cadavers (five female) were performed. Before the dissection, the exact number of lymph nodes was determined sonographically by an experienced radiologist, and their distance from the jugular notch was measured. After anatomic dissection, the vascular pedicle's diameter and length were measured. Results: The mean number of lymph nodes was 1.5 +/- 1.85 on the right side and 3 +/- 2.26 on the left. Their mean distance from the jugular notch was 8.29 +/- 2.15 cm on the right and 6.10 +/- 1.21 cm on the left. The pedicle's length was 4.72 +/- 1.03 cm on the right and 4.86 +/- 0.99 cm on the left, and its diameter 2.03 +/- 0.83 on the right and 1.80 +/- 0.77 on the left. Conclusion: The pedicle length and diameter of the supraclavicular lymph node flap are suitable for a microvascular tissue transfer. (C) 2016 Wiley Periodicals, Inc.