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Head and Neck Reconstruction with Venous Flap: A Case Report
Ali R Abtahi1, Catherine Coyne2, Andrei Odobescu3
1Division of Plastic and Reconstructive Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
Plastic and Reconstructive Surgery. Global Open
|September 22, 2021
Summary
Venous flaps offer a reliable solution for facial defect reconstruction. This study details successful use of an arterialized venous free flap and valvulotomes to restore perfusion in a complex forehead reconstruction.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Vascular Surgery
Background:
- Venous flaps utilize the venous system for both inflow and outflow, presenting unique reconstructive challenges.
- Reliability of venous flaps can be enhanced through physiological manipulation, such as shunt restriction.
- Their pliable tissue and low donor site morbidity make them suitable for moderate facial defects.
Observation:
- A large (70 cm²) arterialized venous free flap was employed for forehead defect reconstruction post-basal cell carcinoma resection.
- Several in-series valves impeded flap perfusion in a large, reverse flow arterialized venous flap.
- Valvulotomes were successfully used to remove these obstructive valves.
Findings:
- Complete flap perfusion was achieved after valve removal.
- This demonstrates the efficacy of valvulotomes in overcoming perfusion issues in complex venous flaps.
- Arterialized venous free flaps are viable options for significant facial reconstruction.
Implications:
- This technique expands the utility of venous flaps in reconstructive surgery.
- The use of valvulotomes offers a novel solution for perfusion challenges in venous free flaps.
- Successful reconstruction highlights the potential for improved patient outcomes in complex facial defects.
