The radial forearm free flap as a "vascular bridge" for secondary microsurgical head and neck reconstruction in a vessel-depleted neck

Pedro Ciudad, Mouchammed Agko, Shivprasad Date, Wei-Ling Chang, Oscar J Manrique, Tony C T Huang, Federico Lo Torto, Emilio Trignano, Hung-Chi Chen

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

BACKGROUND: In a vessel-depleted neck, distant recipient sites may be the only option for secondary free flap reconstruction. While interposition vein grafts and arteriovenous loops can bridge the gap between the recipient and donor pedicle, they are not without risks. In these scenarios, we examinate the reliablity of a radial forearm free flap (RFFF) as an alternative vascular conduit.

PATIENTS AND METHODS: A retrospective review of cases between March 2005 and May 2016 was performed. Demographic data, prior surgical history, intraoperative details and outcomes were recorded. A total of ten patients, eight male and two female, with a mean age of 54.2 years (range, 39-74) were identified. The RFFF was initially anastomosed to either the thoracoacromial (n = 6) or internal mammary vessels (n = 4) and subsequently served as the recipient pedicle for the second "main" flap, an anterolateral thigh (n = 4), jejunum (n = 3) or fibula flap (n = 3).

RESULTS: The average RFFF dimensions were 13.8 cm by 5.8 cm. All twenty flaps, ten RFFF and ten "main' flaps survived completely with only one case of minimal epidermal loss. One patient with esophageal reconstruction with jejunum developed a fistula that required closure with a local falp. At a mean follow-up of 18.4 months (range 8-29), the reconstructive goals had been achieved in all cases.

CONCLUSIONS: The RFFF serves as a reliable "vascular bridge" that extends the reach of distant recipient sites to free flaps in secondary head and neck reconstruction.

Original languageEnglish (US)
Pages (from-to)651-658
Number of pages8
JournalMicrosurgery
Volume38
Issue number6
DOIs
StatePublished - Sep 2018
Externally publishedYes

Fingerprint

Free Tissue Flaps
Forearm
Blood Vessels
Neck
Head
Jejunum
Fibula
Thigh
Fistula
Veins
Breast
History
Demography
Tissue Donors
Transplants

Cite this

The radial forearm free flap as a "vascular bridge" for secondary microsurgical head and neck reconstruction in a vessel-depleted neck. / Ciudad, Pedro; Agko, Mouchammed; Date, Shivprasad; Chang, Wei-Ling; Manrique, Oscar J; Huang, Tony C T; Lo Torto, Federico; Trignano, Emilio; Chen, Hung-Chi.

In: Microsurgery, Vol. 38, No. 6, 09.2018, p. 651-658.

Research output: Contribution to journalArticle

Ciudad, P, Agko, M, Date, S, Chang, W-L, Manrique, OJ, Huang, TCT, Lo Torto, F, Trignano, E & Chen, H-C 2018, 'The radial forearm free flap as a "vascular bridge" for secondary microsurgical head and neck reconstruction in a vessel-depleted neck', Microsurgery, vol. 38, no. 6, pp. 651-658. https://doi.org/10.1002/micr.30259
Ciudad, Pedro ; Agko, Mouchammed ; Date, Shivprasad ; Chang, Wei-Ling ; Manrique, Oscar J ; Huang, Tony C T ; Lo Torto, Federico ; Trignano, Emilio ; Chen, Hung-Chi. / The radial forearm free flap as a "vascular bridge" for secondary microsurgical head and neck reconstruction in a vessel-depleted neck. In: Microsurgery. 2018 ; Vol. 38, No. 6. pp. 651-658.
@article{10d8d8eaaffa43329d327cd3704664ad,
title = "The radial forearm free flap as a {"}vascular bridge{"} for secondary microsurgical head and neck reconstruction in a vessel-depleted neck",
abstract = "BACKGROUND: In a vessel-depleted neck, distant recipient sites may be the only option for secondary free flap reconstruction. While interposition vein grafts and arteriovenous loops can bridge the gap between the recipient and donor pedicle, they are not without risks. In these scenarios, we examinate the reliablity of a radial forearm free flap (RFFF) as an alternative vascular conduit.PATIENTS AND METHODS: A retrospective review of cases between March 2005 and May 2016 was performed. Demographic data, prior surgical history, intraoperative details and outcomes were recorded. A total of ten patients, eight male and two female, with a mean age of 54.2 years (range, 39-74) were identified. The RFFF was initially anastomosed to either the thoracoacromial (n = 6) or internal mammary vessels (n = 4) and subsequently served as the recipient pedicle for the second {"}main{"} flap, an anterolateral thigh (n = 4), jejunum (n = 3) or fibula flap (n = 3).RESULTS: The average RFFF dimensions were 13.8 cm by 5.8 cm. All twenty flaps, ten RFFF and ten {"}main' flaps survived completely with only one case of minimal epidermal loss. One patient with esophageal reconstruction with jejunum developed a fistula that required closure with a local falp. At a mean follow-up of 18.4 months (range 8-29), the reconstructive goals had been achieved in all cases.CONCLUSIONS: The RFFF serves as a reliable {"}vascular bridge{"} that extends the reach of distant recipient sites to free flaps in secondary head and neck reconstruction.",
author = "Pedro Ciudad and Mouchammed Agko and Shivprasad Date and Wei-Ling Chang and Manrique, {Oscar J} and Huang, {Tony C T} and {Lo Torto}, Federico and Emilio Trignano and Hung-Chi Chen",
note = "{\circledC} 2018 Wiley Periodicals, Inc.",
year = "2018",
month = "9",
doi = "10.1002/micr.30259",
language = "English (US)",
volume = "38",
pages = "651--658",
journal = "Microsurgery",
issn = "0738-1085",
publisher = "Wiley-Liss Inc.",
number = "6",

}

TY - JOUR

T1 - The radial forearm free flap as a "vascular bridge" for secondary microsurgical head and neck reconstruction in a vessel-depleted neck

AU - Ciudad, Pedro

AU - Agko, Mouchammed

AU - Date, Shivprasad

AU - Chang, Wei-Ling

AU - Manrique, Oscar J

AU - Huang, Tony C T

AU - Lo Torto, Federico

AU - Trignano, Emilio

AU - Chen, Hung-Chi

N1 - © 2018 Wiley Periodicals, Inc.

PY - 2018/9

Y1 - 2018/9

N2 - BACKGROUND: In a vessel-depleted neck, distant recipient sites may be the only option for secondary free flap reconstruction. While interposition vein grafts and arteriovenous loops can bridge the gap between the recipient and donor pedicle, they are not without risks. In these scenarios, we examinate the reliablity of a radial forearm free flap (RFFF) as an alternative vascular conduit.PATIENTS AND METHODS: A retrospective review of cases between March 2005 and May 2016 was performed. Demographic data, prior surgical history, intraoperative details and outcomes were recorded. A total of ten patients, eight male and two female, with a mean age of 54.2 years (range, 39-74) were identified. The RFFF was initially anastomosed to either the thoracoacromial (n = 6) or internal mammary vessels (n = 4) and subsequently served as the recipient pedicle for the second "main" flap, an anterolateral thigh (n = 4), jejunum (n = 3) or fibula flap (n = 3).RESULTS: The average RFFF dimensions were 13.8 cm by 5.8 cm. All twenty flaps, ten RFFF and ten "main' flaps survived completely with only one case of minimal epidermal loss. One patient with esophageal reconstruction with jejunum developed a fistula that required closure with a local falp. At a mean follow-up of 18.4 months (range 8-29), the reconstructive goals had been achieved in all cases.CONCLUSIONS: The RFFF serves as a reliable "vascular bridge" that extends the reach of distant recipient sites to free flaps in secondary head and neck reconstruction.

AB - BACKGROUND: In a vessel-depleted neck, distant recipient sites may be the only option for secondary free flap reconstruction. While interposition vein grafts and arteriovenous loops can bridge the gap between the recipient and donor pedicle, they are not without risks. In these scenarios, we examinate the reliablity of a radial forearm free flap (RFFF) as an alternative vascular conduit.PATIENTS AND METHODS: A retrospective review of cases between March 2005 and May 2016 was performed. Demographic data, prior surgical history, intraoperative details and outcomes were recorded. A total of ten patients, eight male and two female, with a mean age of 54.2 years (range, 39-74) were identified. The RFFF was initially anastomosed to either the thoracoacromial (n = 6) or internal mammary vessels (n = 4) and subsequently served as the recipient pedicle for the second "main" flap, an anterolateral thigh (n = 4), jejunum (n = 3) or fibula flap (n = 3).RESULTS: The average RFFF dimensions were 13.8 cm by 5.8 cm. All twenty flaps, ten RFFF and ten "main' flaps survived completely with only one case of minimal epidermal loss. One patient with esophageal reconstruction with jejunum developed a fistula that required closure with a local falp. At a mean follow-up of 18.4 months (range 8-29), the reconstructive goals had been achieved in all cases.CONCLUSIONS: The RFFF serves as a reliable "vascular bridge" that extends the reach of distant recipient sites to free flaps in secondary head and neck reconstruction.

U2 - 10.1002/micr.30259

DO - 10.1002/micr.30259

M3 - Article

C2 - 29105820

VL - 38

SP - 651

EP - 658

JO - Microsurgery

JF - Microsurgery

SN - 0738-1085

IS - 6

ER -