Semi‐free radial forearm flap for head and neck reconstruction in vessel‐depleted neck after radiotherapy or radical neck dissection

Abstract

The SF-RFF is a reliable and versatile procedure for facial, oral, or larynx reconstruction. This hybrid version of the radial forearm free flap is particularly appropriate when no suitable recipient veins are available as a result of radiation or prior surgery.

Influence of neck dissection and preoperative irradiation on microvascular head and neck reconstruction-Analysis of 853 cases

“…However in their study of 60 free flaps done after previous neck dissection, Head et al reported no cases of free flap failures . Quilichini et al used cephalic vein in vessel‐depleted neck after radiotherapy or radical neck dissection to achieve successfully in free tissue transfers for head and neck reconstruction . Consequently, the next question we seek to answer is whether free tissue transfer is safe in patients that had undergone both previous radiotherapy and neck dissection.…”

The Role of Free Tissue Transfer in Merkel Cell Carcinoma of the Head and Neck

“…The reliable pedicle length and predictability of harvest make the radial forearm free flap a commonly utilized reconstructive technique for cutaneous defects of the head and neck. In cases with vessel-depleted necks where veins are unavailable, a semifree radial forearm harvest has been described dissecting the cephalic vein proximally and performing a single arterial anastomosis, which is unique to this flap [23]. Donor site morbidity is well tolerated, however generally inferior to the anterior thigh flap [24, 25] (Figures 2, 3, and 4).…”

Free flap transplantation using an extracorporeal perfusion device: First three cases

“…In such situations, recipient vessels of the thoracoacromial or cephalic system can provide an alternative source of blood supply. However, vein grafts or vascular loops are necessary to provide a pedicle long enough for tensionless anastomosis (Urken et al, 2006;Ethunandan et al, 2007;Aycock et al, 2008;Quilichini et al, 2012;Roche et al, 2012;Karle et al, 2013), significantly increasing the risk for flap loss (Bozikov and Arnez, 2006). For these patients, we described a temporary perfusion of composite fibular flaps by anastomosing the flaps to the radial vessels ("carrier flap") with long-term fixation of the arm in an elevated position (Wolff et al, 2003(Wolff et al, , 2009.…”