The subscapular vein is the largest tributary of the axillary vein, draining the subscapularis, serratus anterior, and latissimus dorsi regions. Its trunk is formed by the confluence of the thoracodorsal vein and circumflex scapular vein in the axilla.
The subscapular vein trunk is the primary venous landmark in axillary dissection, where it must be identified before ligation of specific tributaries. In latissimus dorsi flap harvest, the thoracodorsal vein draining into the subscapular trunk is the venous pedicle and must be preserved. Axillary vein thrombosis involving the subscapular trunk produces lateral arm swelling and heaviness.
Inadvertent laceration of the subscapular vein trunk during axillary node dissection producing significant venous haemorrhage requiring direct suture repair to prevent haematoma and thoracodorsal flap compromise.
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