INTRODUCTION: We present a retrospective analysis of 106 radial forearm free flaps (RFFFs) using double venous anastomoses as performed at Northampton General Hospital over an 11-year period. The aim was to assess the failure rate and salvage rate for venous thrombosis of these flaps. METHODS: RFFFs were raised with the cephalic vein where possible. The cephalic vein and 1 venae commitantes or 2 venae commitantes (VC) were anastomosed using microscope assistance. The veins were anastomosed end to side on to the internal jugular vein (IJV). Data was collected from patient notes using a proforma and entered onto an Access database. RESULTS: Of the 106 RFFFs there was 1 (0.94%) failure at day 9, a presumed arterial failure. None of the 106 RFFFs were returned to theatre for salvage for venous thrombosis. CONCLUSION: Our results compare favourably with similar published data. Comparable studies gave a mean failure rate of 4% (range of 0-10%) and 7% (range 3-12.5%). We believe our results are due to: 1--Double venous anastomosis, 2--end to side anastomosis to the IJV using deep and superficial systems, 3--initial anastomosis of the cephalic vein low in the neck to shorten ischaemic time. 4--overnight sedation and ventilation of the patient on the intensive care unit.
INTRODUCTION: We present a retrospective analysis of 106 radial forearm free flaps (RFFFs) using double venous anastomoses as performed at Northampton General Hospital over an 11-year period. The aim was to assess the failure rate and salvage rate for venous thrombosis of these flaps. METHODS: RFFFs were raised with the cephalic vein where possible. The cephalic vein and 1 venae commitantes or 2 venae commitantes (VC) were anastomosed using microscope assistance. The veins were anastomosed end to side on to the internal jugular vein (IJV). Data was collected from patient notes using a proforma and entered onto an Access database. RESULTS: Of the 106 RFFFs there was 1 (0.94%) failure at day 9, a presumed arterial failure. None of the 106 RFFFs were returned to theatre for salvage for venous thrombosis. CONCLUSION: Our results compare favourably with similar published data. Comparable studies gave a mean failure rate of 4% (range of 0-10%) and 7% (range 3-12.5%). We believe our results are due to: 1--Double venous anastomosis, 2--end to side anastomosis to the IJV using deep and superficial systems, 3--initial anastomosis of the cephalic vein low in the neck to shorten ischaemic time. 4--overnight sedation and ventilation of the patient on the intensive care unit.
Authors: John W Frederick; Larissa Sweeny; William R Carroll; Eben L Rosenthal Journal: Otolaryngol Head Neck Surg Date: 2013-04-12 Impact factor: 3.497
Authors: Jun Ho Lee; Hwan Jun Choi; Si Hyun Kwak; Da Woon Lee; Min Sung Tak; Jin Seok Kang Journal: Medicine (Baltimore) Date: 2021-07-09 Impact factor: 1.817