Interposition Vein Grafting in Head and Neck Free Flap Reconstruction

Plastic and Reconstructive Surgery
Marco MaricevichMatthew M Hanasono

Abstract

Many surgeons are hesitant to use interposition vein grafting in head and neck microvascular free flap surgery because of concerns for elevated risk of flap loss. The authors conducted a review of patients who underwent head and neck free flap reconstruction between 2005 and 2015. The effect of vein grafts on flap compromise and flap loss was analyzed using univariate and multivariate models. A total of 3240 free flaps were performed. Vein grafts were used in 241 flaps (7.4 percent). The free flap compromise rate was 14.5 percent with vein grafts and 3.4 percent without vein grafts (p < 0.001). The free flap loss rate was 6.4 percent with vein grafts and 1.1 percent without vein grafts (p < 0.001). Radiation therapy, chemotherapy, prior neck dissection, prior free flap, osteoradionecrosis, and multiple free flap surgery were more frequent within the vein graft group (all p < 0.001). Despite this, vein grafting was associated with an increased risk of flap compromise (adjusted OR, 4.8; 95 percent CI, 3.2 to 7.3; p < 0.001) and flap loss (adjusted OR, 5.5; 95 percent CI, 3.0 to 10.2; p < 0.001) on multivariable analysis. Individual review of each flap loss within the vein graft group identified no cases of thrombosis caused by an...Continue Reading

References

Mar 1, 1994·Plastic and Reconstructive Surgery·M A SchustermanH Goepfert
May 1, 1993·Journal of Reconstructive Microsurgery·M J MillerS S Kroll
Jan 1, 1996·Journal of Reconstructive Microsurgery·G Germann, H U Steinau
Jan 5, 2002·Annals of Plastic Surgery·Mehmet BayramiçliFeyyaz Baltaci
May 18, 2006·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·S PodreccaR Molinari
Oct 24, 2008·Microsurgery·Matthew M HanasonoRoman J Skoracki
Apr 18, 2009·Head & Neck·Matthew M HanasonoDavid W Chang
Mar 25, 2011·The Laryngoscope·Maxwell C FurrMark K Wax
Mar 1, 2012·Plastic and Reconstructive Surgery·Albert H ChaoMatthew M Hanasono
May 1, 2012·Plastic and Reconstructive Surgery·Hsu-Tang ChengSophia Chia-Ning Chang

❮ Previous
Next ❯

Citations

Aug 28, 2019·Techniques in Hand & Upper Extremity Surgery·David E KurlanderJames Gatherwright
Mar 4, 2020·Archives of Craniofacial Surgery·Hyeong Seop KimYong Joon Chang
Feb 11, 2021·Plastic and Reconstructive Surgery. Global Open·Luís VieiraAndres Rodriguez-Lorenzo
Feb 11, 2021·Plastic and Reconstructive Surgery·Sarah A FrommerSteven L Henry
Feb 16, 2021·Plastic and Reconstructive Surgery·Zeynep Akdeniz-DoganAlexander F Mericli
Feb 24, 2021·International Journal of Oral and Maxillofacial Surgery·A Bueno de VicenteJ Acero
Apr 15, 2021·Journal of Reconstructive Microsurgery·Anjali C RaghuramMarco Maricevich
May 12, 2021·Plastic and Reconstructive Surgery·Rene D LargoEdward I Chang
Aug 31, 2021·Journal of Surgical Case Reports·Chih-Hsun LinHsu Ma
Dec 19, 2021·Journal of Reconstructive Microsurgery·Ping Song, Lee L Q Pu
Feb 4, 2022·Facial Plastic Surgery : FPS·Elisabeth GréantCallum Faris

❮ 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.