A reliable method for monitoring the microvascular patency of free jejunal transfers in reconstructing the pharynx and cervical esophagus.

Reconstruction of the pharynx and esophagus with revascularized segments of jejunum remains a time-proven entity. Most thromboses and subsequent flap failures have occurred within the first 24 hours after revascularization of the flap. What would therefore be desirable is a safe, proven monitoring system to assess the patency of the microvascular anastomoses and subsequent viability of the transferred bowel segment. This paper reports on such a monitoring system, which involves the creation of a surgical window on the anterior cervical flap. The jejunal serosa is tacked to this window, and a thin split-thickness skin graft is placed directly on the bowel. The technique is simple, safe, efficacious, and leaves no significant defect.