Where the first choice of flap is not available for reconstruction in the head and neck (often during salvage) the pedicle may not be long enough to allow tension-free anastomosis, which can lead to a greater risk of failure. Interpositional vein grafts are an accepted technique to provide a greater length of pedicle,1 and those most commonly used are the cephalic, external jugular, or long saphenous veins. We describe a patient in whom none of these were suitable and so the superficial inferior epigastric vein was used to good effect.
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