Blood supply to the nape-of-the-neck flap: implications from a fetal anatomical study.

The blood supply to the nape-of-the-neck flap was studied in 11 18-week-old fetuses by infusion of methyl methacrolate into the vascular system. Dissection of the posterior cervical region showed that the major blood supply to this area was through perforating vessels from the superficial portion of the ramus decendens of the occipital artery and the posterior auricular artery. Since a "named artery" was not found in the longitudinal axis of the flap, as is reported in the literature, it should be considered a cutaneous rather than an arterial flap. The findings of this study are consisted with classical anatomical descriptions about blood supply to this region. Collateral vascular pathways from the occipital artery and the corticervical trunk are discussed.