Monitoring free vascularised jejunum grafts.

A reliable method of monitoring free vascularised jejunum to the head and neck region has been used in six patients. Preliminarily, the jejunum island flap is subdivided into major and minor segments. Transferred to the neck, the major part is used to reconstruct the oesophageal or pharyngeal defect, while the minor part supplied by the same segmental mesenteric artery is exteriorised through the neck incision. After five days direct monitoring, the marker segment is clamped, tied and excised before suturing the neck wound under local anaesthesia. No failures of the graft occurred. The effectiveness of this technique has surpassed all previously published and unpublished methods.