Document Detail


Double venous anastomosis for the radial artery forearm flap. Improving success and minimising morbidity.
MedLine Citation:
PMID:  19144528     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
Mark Jürgen Alan Turner; William P Smith
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Publication Detail:
Type:  Journal Article     Date:  2009-01-13
Journal Detail:
Title:  Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery     Volume:  37     ISSN:  1878-4119     ISO Abbreviation:  J Craniomaxillofac Surg     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-15     Completed Date:  2009-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8704309     Medline TA:  J Craniomaxillofac Surg     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  253-7     Citation Subset:  D; IM    
Affiliation:
Maxillofacial Unit, Northampton General Hospital, Cliftonville, Northampton, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anastomosis, Surgical / methods*
Carcinoma, Squamous Cell / rehabilitation,  surgery
Female
Forearm / blood supply
Graft Survival
Head and Neck Neoplasms / rehabilitation*,  surgery
Humans
Male
Middle Aged
Radial Artery / transplantation*
Reoperation / statistics & numerical data
Retrospective Studies
Skin / blood supply*
Skin Transplantation / methods
Surgical Flaps* / blood supply
Tissue and Organ Harvesting / methods
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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