The park-bench position in cervico-facial reconstructive surgery: a technical note

Resection and simultaneous reconstruction with free flaps of wide tumours of the scalp and posterior neck region are difficult to perform through a single surgical approach. In such cases, the park-bench position – a lateral oblique position – could allow simultaneous resection and reconstruction of tumours of the scalp and occipital region without changing the patient's position. In the case described here, this position was used to treat microcystic adnexal carcinoma in a patient who presented with three scalp lesions and a lesion of the right scapular region. This arrangement allowed both resection and reconstruction with a microvascular flap without changing the patient's position, as a result of being able to find neck vessels suitable for microanastomosis. Reconstruction was carried out using a right latissimus dorsi myogenous and subcutaneous flap, and anastomoses were created between the thoracodorsal artery and vein, and the transverse cervical artery and vein. In this position, transverse cervical vessels are well placed, with good exposure, and are in an optimal location for use in microvascular surgery. At 8 months post-reconstruction, the patient was in good condition without local recurrence or distant metastases, and the flap showed a good lining and contour. In conclusion, the park-bench position facilitates surgical excision, flap harvesting and microsurgery in the same patient position.