An old controversy revisited-one versus two venous anastomoses in microvascular head and neck reconstruction using anterolateral thigh flap
Background The necessity of a second venous anastomosis in free tissue transfer is controversial. We review a single surgeon's 8‐year experience of head and neck reconstruction using free anterolateral flap reconstruction to assess the need for a second venous anastomosis. Patients and method T...
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Published in | Microsurgery Vol. 34; no. 5; pp. 377 - 383 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Blackwell Publishing Ltd
01.07.2014
Wiley Subscription Services, Inc |
Subjects | |
Online Access | Get full text |
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Summary: | Background
The necessity of a second venous anastomosis in free tissue transfer is controversial. We review a single surgeon's 8‐year experience of head and neck reconstruction using free anterolateral flap reconstruction to assess the need for a second venous anastomosis.
Patients and method
Three hundred and fifteen cases were included in the study after selecting only for anterolateral thigh flap, head, and neck reconstruction, and those that used superior thyroid artery as recipient. The selection criteria were designed to create as homogeneous a group as possible to decrease confounding factors.
Results
The group with single anastomosis required more frequent take‐backs than the group with dual anastomoses (19% vs 10.8%, P = 0.055). The trend persisted when only take‐backs for venous insufficiencies were compared (8.2% vs 2.5%, P = 0.039). When flaps with single anastomosis developed venous congestion, they were more likely to require operative salvage for venous insufficiency than those with dual anastomoses (35.5% vs. 6.3%, P = 0.037). No difference was found in postoperative complications and flap survival.
Conclusion
Our data suggest that flaps with single venous anastomosis are more likely to require take‐back for flap salvage than those with dual anastomoses. © 2013 Wiley Periodicals, Inc. Microsurgery 34:377–383, 2014. |
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Bibliography: | ark:/67375/WNG-G3VP6Z8H-S istex:539AA1AC06AB1875E6B182650A5495E0413C9983 ArticleID:MICR22214 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0738-1085 1098-2752 |
DOI: | 10.1002/micr.22214 |