Analysis of 13 cases of venous compromise in 178 radial forearm free flaps for intraoral reconstruction

International Journal of Oral and Maxillofacial Surgery
Y LiuR H Shi

Abstract

The purpose of this study was to analyse the causes of venous compromise and flap failure in radial forearm free flap (RFFF) surgery for intraoral reconstruction. One hundred seventy-eight RFFF reconstructions were reviewed retrospectively for intraoral defects. Of the 13 flaps with venous obstruction, 9 flaps were salvaged, and 4 were lost, with a salvage rate of 69.2%. Eleven venous occlusions occurred within the first 72h. The main reasons for venous failure were mechanical obstruction or technical errors due to inadequate pedicle length and geometry, inadequate venous drainage, compression and kinking of the vein. The main cause of failure for oropharynx reconstruction was unrecognized vascular events due to the lack of reliable monitoring for buried flap. Oozing of dusky blood from the flap margin may be directly related to venous congestion in the early postoperative period and a late indication of a change in skin colour. In conclusion, a thorough operative plan, including carefully selected drainage vein for the flap and recipient vessels, adequate pedicle length and geometry, precise surgical technique, avoidance of haematoma, and expert monitoring of buried flaps may improve the success rate of RFFF transfer in intrao...Continue Reading

References

Dec 1, 1996·Plastic and Reconstructive Surgery·S S KrollB J Baldwin
Sep 4, 1998·Plastic and Reconstructive Surgery·R K KhouriC Wallemark
Jan 8, 2000·Plastic and Reconstructive Surgery·J C Yuen, Z Feng
Feb 11, 2003·The British Journal of Oral & Maxillofacial Surgery·J S BrownE D Vaughan
Sep 11, 2003·Journal of Wound Care·J C DevineE D Vaughan
Sep 30, 2003·Journal of Reconstructive Microsurgery·Akihiro IchinoseMiki Saito
Sep 30, 2006·Clinical Oral Investigations·Philipp PohlenzMax Heiland
Oct 4, 2006·Plastic and Reconstructive Surgery·Keith A HurvitzGregory R D Evans
Oct 19, 2006·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Raul PelliniGiuseppe Spriano
May 9, 2007·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·R RhemrevS O P Hofer
May 24, 2007·Plastic and Reconstructive Surgery·Duc T BuiBabak J Mehrara
Sep 18, 2007·Microsurgery·Jeroen M SmitEd H M Hartman
Sep 29, 2007·Annals of Plastic Surgery·Johnson Chia-Shen YangSeng-Feng Jeng
Jul 23, 2008·Archives of Otolaryngology--head & Neck Surgery·Jennifer P GuillemaudJeffrey R Harris
Dec 1, 2009·International Journal of Oral and Maxillofacial Surgery·F HölzleK-D Wolff

❮ Previous
Next ❯

Citations

Jul 11, 2013·Current Opinion in Otolaryngology & Head and Neck Surgery·Hans-J WelkoborskyMichael L Hinni
Feb 7, 2016·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Zhao-Jian GongHan-Jiang Wu
Sep 1, 2015·Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery·Christian BrandtnerAlexander Gaggl
Feb 18, 2014·Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery·Tetsuji NagataFuminori Katou
Apr 15, 2015·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Zhao-Jian GongHan-Jiang Wu
Oct 3, 2014·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Mehmet Ali AcarFaik Türkmen
Oct 6, 2012·Annals of Plastic Surgery·Daniel ChubbWilliam C Lineaweaver
Jun 26, 2015·Plastic and Reconstructive Surgery·Jignesh V UnadkatMichael L Gimbel
Dec 28, 2019·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Rikuo ShinomiyaNobuo Adachi
Apr 28, 2016·Plastic and Reconstructive Surgery·Benoit ChaputGuillaume de Bonnecaze
Feb 27, 2015·Plastic and Reconstructive Surgery·Kenneth L FanKaren K Evans
Apr 30, 2019·The Laryngoscope·Marc A PolaccoEunice Y Chen
May 5, 2017·The Journal of Craniofacial Surgery·Xiaoqiang ZhaoYong Wu
Nov 26, 2015·Plastic and Reconstructive Surgery·Samuel RiotBenoit Chaput
May 31, 2018·Plastic Surgery·Jennifer L K MatthewsSophocles H Voineskos
Sep 25, 2019·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Shou-Cheng YinChang-Fu Sun
Dec 10, 2020·International Journal of Oral and Maxillofacial Surgery·Y XieY Wang
May 18, 2021·OTO Open : the Official Open Access Journal of the American Academy of Otolaryngology--Head and Neck Surgery Foundation·Mauricio Alejandro MorenoJumin Sunde

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.