Proper Choice of Donor Site Veins for Patients Undergoing Free Radial Forearm Flap Reconstruction for the Defects of Head and Neck

Zhai, Qin-kai; Dai, Wei; Tan, Xiaoheng; Sun, Jian; Zhang, Chenping; Qin, Xiaoqun

doi:10.1016/j.joms.2017.07.170

Cited by 8 publications

(9 citation statements)

References 18 publications

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“…Of note, even in severely atherosclerotic patients, the lower extremity vena comitans never demonstrate intimal plaque. In addition, multiple studies have evidence to suggest that the deep system is less prone to venous thombosis 12,13 …”

Section: Methodsmentioning

confidence: 99%

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Venous Anastomoses in Anterolateral Thigh Flaps for the Lower Extremity

et al. 2023

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BackgroundDual venous drainage for anterolateral thigh flaps has been proposed to protect against flap-related complications in head and neck applications. Here we report our experience with single vs dual venous anastomosis during lower extremity free-tissue transfer.MethodsAll free anterolateral thigh flaps for lower extremity reconstruction from 2011 to 2017 were retrospectively reviewed. An algorithm was used to determine the type and number of venous anastomoses, emphasizing patient anatomy, venous quality, and size match. Patients were divided into single- and dual-venous-anastomosis groups. Univariate analysis determined differences between the groups. A multivariable analysis identified independent risk factors.ResultsFifty patients met the inclusion criteria. Patient demographics, recipient sites, wound type, and flap characteristics were similar in 1 and 2 vein groups. Average follow-up was 9.6 months. Forty-two percent underwent single venous drainage anastomoses. Mean age was 52.7 years, 78.0% were male, and 60% had defects of the foot and ankle. Increased flap area and early dangling did not increase flap demise. Thirty-three percent of single-drainage patients and 31.0% of dual-drainage patients had a complication. A body mass index of greater than 30 kg/m2 was a predictor for both flap complication (P = 0.025) and partial flap loss (P = 0.031) in univariate analysis. No independent predictors were found in multivariate analysis.ConclusionsThe number of venous anastomoses, area, and dangling protocol did not influence outcomes while using our lower extremity vein method. Thoughtful evaluation of venous egress should outweigh the routine use of multiple veins in perforator flap reconstructions of the lower extremity.

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Section: Methodsmentioning

confidence: 99%

“…In addition, multiple studies have evidence to suggest that the deep system is less prone to venous thombosis. 12,13 Venous targets are identified outside the zone of injury and or wound, selected based on appearance: lack of scar or fibrosis, and presence and nature of back-flow bleeding. Next, we optimize size match (Fig.…”

Section: Surgical Techniquementioning

confidence: 99%

Venous Anastomoses in Anterolateral Thigh Flaps for the Lower Extremity

et al. 2023

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“…The left wound can cause obvious postoperative scar and reduce patient satisfaction. 12,13 A peroneal artery perforator flap is mainly supported by the blood vessels of the artery penetration. Anatomical research has found that the peroneal artery is composed of ~4 to 6 clinical blood vessels which helps to formulate a relatively constant anatomy position.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Survival Quality of Peroneal Artery Perforator Flap in Immediate Repairment and Reconstruction of Oral and Maxillofacial Malignancies

Song

Liang

Qian

et al. 2023

Journal of Craniofacial Surgery

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Objective: This study aimed to investigate the survival quality of peroneal artery perforator flap in the reconstruction of oral and maxillofacial malignant tumors. Methods: Thirty-two cases with a diagnosis of oral and maxillofacial malignant tumors admitted to our hospital from January 2019 to December 2019 were randomly divided into 2 groups. The observation group was reconstructed with free open artery perforator flaps, and the control group was repaired with free forearm flaps. Results: The observation group had significantly lower scores in terms of postoperative pain, appearance, and anxiety, compared with the control group (P<0.05). Both groups had high scores on taste, saliva, and shoulder function although there was no significant difference (P>0.05). The scores of the observation group were significantly higher than those in the control group in terms of chewing, swallowing, speech, activity, mood, and entertainment (P<0.05). There was 1 case accompanied by postoperative wound dehiscence and 2 cases with wound infection in the observation group while there were 3 cases with wound dehiscence and 2 cases with wound infection in the control group (P>0.05). Conclusion: Compared with the forearm flap, the peroneal artery perforator flap can improve the survival quality of patients, especially in postoperative function with the fibula joint to repair the oral and maxillofacial defects. It has a wide application prospect as one of the ideal flaps in oral and maxillofacial postoperative repair and reconstruction.

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“…Although some surgeons advocate for a single, superficial venous anastomosis with good success, 21,22 others report higher failure rates due to venous thrombosis when the superficial system is used alone for flap drainage. 23,24 There are proponents of using the deep system alone for flap drainage. 25 Studies have documented the reliability of using a single vena comitans for flap drainage.…”

Section: Discussionmentioning

confidence: 99%