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Fail-safe drainage procedure in free radial forearm flap transfer
Akihiro Ichinose1, Shinya Tahara, Satoshi Yokoo
1Department of Plastic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
Journal of Reconstructive Microsurgery
|September 30, 2003
Summary
A novel dual venous drainage system for free radial forearm flaps significantly reduces venous thrombosis. This reliable method ensures flap survival by connecting superficial and deep veins to neck recipient vessels, preventing venous failure.
Area of Science:
- Plastic Surgery
- Vascular Surgery
- Microsurgery
Background:
- Free radial forearm flap is a reliable reconstructive method.
- Postoperative venous thrombosis remains a complication, necessitating improved drainage strategies.
Purpose of the Study:
- To evaluate a dual venous drainage system for free radial forearm flaps.
- To establish a fail-safe method to prevent venous thrombosis and flap failure.
Main Methods:
- Retrospective review of 405 free radial forearm flap transfers (1987-2002).
- Implementation of a dual drainage system involving superficial (cutaneous) and deep (radial vena comitans) veins, connected via the cubital perforating vein.
- Anastomosis to internal jugular and external jugular venous systems as recipient vessels.
Main Results:
- The dual drainage method demonstrated zero instances of venous failure across all 405 flap transfers.
- This technique proved effective regardless of the operating surgeon, indicating high reliability.
Conclusions:
- The described dual venous drainage system is a highly reliable and effective method for free radial forearm flap transfers.
- This approach mitigates the risk of venous catastrophe, ensuring flap viability.