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Published in: Maxillofacial Plastic and Reconstructive Surgery 1/2017

Open Access 01-12-2017 | Review

Revisiting radial forearm free flap for successful venous drainage

Authors: Yong Hoon Cha, Woong Nam, In-Ho Cha, Hyung Jun Kim

Published in: Maxillofacial Plastic and Reconstructive Surgery | Issue 1/2017

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Abstract

Tissue defect reconstruction using radial forearm free flap (RFFF) is a common surgical technique whose success or failure is mainly dependent on venous drainage. RFFF has two major venous outflow systems, superficial and deep vein. Drainage methods include combining both systems or using one alone. This review aims to recapitulate the vascular anatomy and network of RFFF as well as shed light on deep vein as a reliable venous drainage system. We also discuss basic evidence for and advantages of single microanastomosis with coalesced vein to overcome technical difficulties associated with the deep vein system.
Literature
1.
go back to reference Yang G, Chen B, Gao Y (1981) Forearm free skin flap transplantation. Natl Med J China 61:139–141 Yang G, Chen B, Gao Y (1981) Forearm free skin flap transplantation. Natl Med J China 61:139–141
2.
go back to reference Song R, Gao Y, Song Y, Yu Y, Song Y (1982) The forearm flap. Clin Plast Surg 9:21–26PubMed Song R, Gao Y, Song Y, Yu Y, Song Y (1982) The forearm flap. Clin Plast Surg 9:21–26PubMed
3.
go back to reference Schusterman MA, Kroll SS, Weber RS, Byers RM, Guillamondegui O, Goepfert H (1991) Intraoral soft tissue reconstruction after cancer ablation: a comparison of the pectoralis major flap and the free radial forearm flap. Am J Surg 162(4):397–399CrossRefPubMed Schusterman MA, Kroll SS, Weber RS, Byers RM, Guillamondegui O, Goepfert H (1991) Intraoral soft tissue reconstruction after cancer ablation: a comparison of the pectoralis major flap and the free radial forearm flap. Am J Surg 162(4):397–399CrossRefPubMed
4.
5.
go back to reference Harii K, Ebihara S, Ono I, Saito H, Terui S, Takato T (1985) Pharyngoesophageal reconstruction using a fabricated forearm free flap. Plast Reconstr Surg 75(4):463–474CrossRefPubMed Harii K, Ebihara S, Ono I, Saito H, Terui S, Takato T (1985) Pharyngoesophageal reconstruction using a fabricated forearm free flap. Plast Reconstr Surg 75(4):463–474CrossRefPubMed
6.
go back to reference Boorman JG, Green MF (1986) A split Chinese forearm flap for simultaneous oral lining and skin cover. Br J Plast Surg 39(2):179–182CrossRefPubMed Boorman JG, Green MF (1986) A split Chinese forearm flap for simultaneous oral lining and skin cover. Br J Plast Surg 39(2):179–182CrossRefPubMed
7.
go back to reference Cheng B (1983) Free forearm flap transplantation in repair and reconstruction of tongue defects. Chinese journal of stomatology 18(1):39 Cheng B (1983) Free forearm flap transplantation in repair and reconstruction of tongue defects. Chinese journal of stomatology 18(1):39
8.
go back to reference Chen HC, Ganos DL, Coessens BC, Kyutoku S, Noordhoff MS (1992) Free forearm flap for closure of difficult oronasal fistulas in cleft-palate patients. Plast Reconstr Surg 90(5):757–762CrossRefPubMed Chen HC, Ganos DL, Coessens BC, Kyutoku S, Noordhoff MS (1992) Free forearm flap for closure of difficult oronasal fistulas in cleft-palate patients. Plast Reconstr Surg 90(5):757–762CrossRefPubMed
9.
go back to reference Hatoko M, Harashina T, Inoue T, Tanaka I, Imai K (1990) Reconstruction of palate with radial forearm flap—a report of 3 cases. Br J Plast Surg 43(3):350–354CrossRefPubMed Hatoko M, Harashina T, Inoue T, Tanaka I, Imai K (1990) Reconstruction of palate with radial forearm flap—a report of 3 cases. Br J Plast Surg 43(3):350–354CrossRefPubMed
10.
go back to reference Soutar DS, Widdowson WP (1986) Immediate reconstruction of the mandible using a vascularized segment of radius. Head & Neck Surgery 8(4):232–246CrossRef Soutar DS, Widdowson WP (1986) Immediate reconstruction of the mandible using a vascularized segment of radius. Head & Neck Surgery 8(4):232–246CrossRef
11.
go back to reference Niranjan N, Watson D (1990) Reconstruction of the cheek using a “suspended” radial forearm free flap. Br J Plast Surg 43(3):365–366CrossRefPubMed Niranjan N, Watson D (1990) Reconstruction of the cheek using a “suspended” radial forearm free flap. Br J Plast Surg 43(3):365–366CrossRefPubMed
12.
go back to reference Sadove RC, Luce EA, McGrath PC (1991) Reconstruction of the lower lip and chin with the composite radial forearm-palmaris longus free flap. Plast Reconstr Surg 88(2):209–214CrossRefPubMed Sadove RC, Luce EA, McGrath PC (1991) Reconstruction of the lower lip and chin with the composite radial forearm-palmaris longus free flap. Plast Reconstr Surg 88(2):209–214CrossRefPubMed
13.
go back to reference Swartz WM, Ramasastry SS, McGill JR, Noonan JD (1987) Distally based vastus lateralis muscle flap for coverage of wounds about the knee. Plast Reconstr Surg 80(2):255–263CrossRefPubMed Swartz WM, Ramasastry SS, McGill JR, Noonan JD (1987) Distally based vastus lateralis muscle flap for coverage of wounds about the knee. Plast Reconstr Surg 80(2):255–263CrossRefPubMed
14.
go back to reference Wei F-C, Mardini S (2009) Flaps and reconstructive surgery. Elsevier Health Sciences, Elsevier Wei F-C, Mardini S (2009) Flaps and reconstructive surgery. Elsevier Health Sciences, Elsevier
15.
go back to reference Wolff K-D, Hölzle F (2011) Raising of microvascular flaps: a systematic approach. Springer Science & Business Media, Springer Wolff K-D, Hölzle F (2011) Raising of microvascular flaps: a systematic approach. Springer Science & Business Media, Springer
16.
go back to reference Godina M (2006) Early microsurgical reconstruction of complex trauma of the extremities. Orthopedic Trauma Directions 4(05):29–35CrossRef Godina M (2006) Early microsurgical reconstruction of complex trauma of the extremities. Orthopedic Trauma Directions 4(05):29–35CrossRef
17.
go back to reference Vaughan ED (1990) The radial forearm free flap in orofacial reconstruction—personal experience in 120 consecutive cases. J Cranio-Maxillofac Surg 18(1):2–7CrossRef Vaughan ED (1990) The radial forearm free flap in orofacial reconstruction—personal experience in 120 consecutive cases. J Cranio-Maxillofac Surg 18(1):2–7CrossRef
18.
go back to reference Soutar DS, McGregor IA (1986) The radial forearm flap in intraoral reconstruction: the experience of 60 consecutive cases. Plast Reconstr Surg 78(1):1–8CrossRefPubMed Soutar DS, McGregor IA (1986) The radial forearm flap in intraoral reconstruction: the experience of 60 consecutive cases. Plast Reconstr Surg 78(1):1–8CrossRefPubMed
19.
go back to reference Shima H, Ohno K, Michi K, Egawa K, Takiguchi R (1996) An anatomical study on the forearm vascular system. J Craniomaxillofac Surg 24(5):293–299CrossRefPubMed Shima H, Ohno K, Michi K, Egawa K, Takiguchi R (1996) An anatomical study on the forearm vascular system. J Craniomaxillofac Surg 24(5):293–299CrossRefPubMed
20.
go back to reference Emerson DJM, Sprigg A, Page RE (1985) Some observations on the radial artery island flap. Br J Plast Surg 38(1):107–112CrossRefPubMed Emerson DJM, Sprigg A, Page RE (1985) Some observations on the radial artery island flap. Br J Plast Surg 38(1):107–112CrossRefPubMed
21.
go back to reference Lin SD, Lai CS, Chiu CC (1984) Venous drainage in the reverse forearm flap. Plast Reconstr Surg 74(4):508–512CrossRefPubMed Lin SD, Lai CS, Chiu CC (1984) Venous drainage in the reverse forearm flap. Plast Reconstr Surg 74(4):508–512CrossRefPubMed
22.
go back to reference Maros T (1980) Data regarding the typology and functional significance of the venous valves. Morphol Embryol 27(3):195–214 Maros T (1980) Data regarding the typology and functional significance of the venous valves. Morphol Embryol 27(3):195–214
23.
go back to reference Timmons MJ (1984) William Harvey revisited—reverse flow through the valves of forearm veins. Lancet 2(8399):394–395CrossRefPubMed Timmons MJ (1984) William Harvey revisited—reverse flow through the valves of forearm veins. Lancet 2(8399):394–395CrossRefPubMed
24.
go back to reference Liu Y, Jiang XZ, Huang JT, Wu Y, Wang GD, Jiang L et al (2008) Reliability of the superficial venous drainage of the radial forearm free flaps in oral and maxillofacial reconstruction. Microsurgery 28(4):243–247CrossRefPubMed Liu Y, Jiang XZ, Huang JT, Wu Y, Wang GD, Jiang L et al (2008) Reliability of the superficial venous drainage of the radial forearm free flaps in oral and maxillofacial reconstruction. Microsurgery 28(4):243–247CrossRefPubMed
25.
go back to reference Futran ND, Stack BC (1996) Single versus dual venous drainage of the radial forearm free flap. Am J Otolaryngol 17(2):112–117CrossRefPubMed Futran ND, Stack BC (1996) Single versus dual venous drainage of the radial forearm free flap. Am J Otolaryngol 17(2):112–117CrossRefPubMed
26.
go back to reference Beckingham IJ, Wilson GR, Mclean NR, Soames JV (1992) Free flap failure due to venous occlusion secondary to previous intravenous cannulation—a case report. Microsurgery 13(6):348–349CrossRefPubMed Beckingham IJ, Wilson GR, Mclean NR, Soames JV (1992) Free flap failure due to venous occlusion secondary to previous intravenous cannulation—a case report. Microsurgery 13(6):348–349CrossRefPubMed
27.
go back to reference Bai S, Xu ZF, Duan WY, Liu FY, Huang DH, Sun CF (2015) Single superficial versus dual systems venous anastomoses in radial forearm free flap: a meta-analysis. PLoS One 10(8):e0134805CrossRefPubMedPubMedCentral Bai S, Xu ZF, Duan WY, Liu FY, Huang DH, Sun CF (2015) Single superficial versus dual systems venous anastomoses in radial forearm free flap: a meta-analysis. PLoS One 10(8):e0134805CrossRefPubMedPubMedCentral
28.
go back to reference Ichinose A, Tahara S, Terashi H, Yokoo S, Nakahara M, Hashikawa K et al (2003) Importance of the deep vein in the drainage of a radial forearm flap: a haemodynamic study. Scand J Plast Reconstr Surg Hand Surg 37(3):145–149CrossRefPubMed Ichinose A, Tahara S, Terashi H, Yokoo S, Nakahara M, Hashikawa K et al (2003) Importance of the deep vein in the drainage of a radial forearm flap: a haemodynamic study. Scand J Plast Reconstr Surg Hand Surg 37(3):145–149CrossRefPubMed
29.
go back to reference Ichinose A, Tahara S, Terashi H, Nomura T, Omori M (2003) Short-term postoperative flow changes after free radial forearm flap transfer: possible cause of vascular occlusion. Ann Plast Surg 50(2):160–164CrossRefPubMed Ichinose A, Tahara S, Terashi H, Nomura T, Omori M (2003) Short-term postoperative flow changes after free radial forearm flap transfer: possible cause of vascular occlusion. Ann Plast Surg 50(2):160–164CrossRefPubMed
30.
go back to reference Demirkan F, Wei FC, Lutz BS, Cher TS, Chen IH (1998) Reliability of the venae comitantes in venous drainage of the free radial forearm flaps. Plast Reconstr Surg 102(5):1544–1548CrossRefPubMed Demirkan F, Wei FC, Lutz BS, Cher TS, Chen IH (1998) Reliability of the venae comitantes in venous drainage of the free radial forearm flaps. Plast Reconstr Surg 102(5):1544–1548CrossRefPubMed
31.
go back to reference Netscher DT, Sharma S, Alford EL, Thornby J, Leibman NS (1996) Superficial versus deep: options in venous drainage of the radial forearm free flap. Ann Plast Surg 36(5):536–541CrossRefPubMed Netscher DT, Sharma S, Alford EL, Thornby J, Leibman NS (1996) Superficial versus deep: options in venous drainage of the radial forearm free flap. Ann Plast Surg 36(5):536–541CrossRefPubMed
32.
go back to reference Thoma A, Archibald S, Jackson S, Young JEM (1994) Surgical patterns of venous drainage of the free forearm flap in head and neck reconstruction. Plast Reconstr Surg 93(1):54–59CrossRefPubMed Thoma A, Archibald S, Jackson S, Young JEM (1994) Surgical patterns of venous drainage of the free forearm flap in head and neck reconstruction. Plast Reconstr Surg 93(1):54–59CrossRefPubMed
33.
go back to reference Chang TS, Hwang WY (1984) Forearm flap in one-stage reconstruction of the penis. Plast Reconstr Surg 74(2):251–258CrossRefPubMed Chang TS, Hwang WY (1984) Forearm flap in one-stage reconstruction of the penis. Plast Reconstr Surg 74(2):251–258CrossRefPubMed
34.
go back to reference Soutar DS (1987) Radial forearm free flap in intraoral reconstruction—the appearance of 100 consecutive cases. Clin Otolaryngol 12(4):309–309CrossRef Soutar DS (1987) Radial forearm free flap in intraoral reconstruction—the appearance of 100 consecutive cases. Clin Otolaryngol 12(4):309–309CrossRef
Metadata
Title
Revisiting radial forearm free flap for successful venous drainage
Authors
Yong Hoon Cha
Woong Nam
In-Ho Cha
Hyung Jun Kim
Publication date
01-12-2017
Publisher
Springer Berlin Heidelberg
Published in
Maxillofacial Plastic and Reconstructive Surgery / Issue 1/2017
Electronic ISSN: 2288-8586
DOI
https://doi.org/10.1186/s40902-017-0110-8

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