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.

journal_name

Microsurgery

journal_title

Microsurgery

authors

Ciudad P,Agko M,Date S,Chang WL,Manrique OJ,Huang TCT,Lo Torto F,Trignano E,Chen HC

doi

10.1002/micr.30259

subject

Has Abstract

pub_date

2018-09-01 00:00:00

pages

651-658

issue

6

eissn

0738-1085

issn

1098-2752

journal_volume

38

pub_type

杂志文章
  • Free jejunal flap transfer containing multiple vascular pedicles for pharyngoesophageal reconstruction in conjunction with anterior mediastinal tracheostomy.

    abstract:BACKGROUND:When pharyngoesophagectomy is performed in conjunction with anterior mediastinal tracheostomy, reconstructing both the trachea and alimentary tract is extremely difficult. We developed a novel 1-stage reconstructive procedure using a single free jejunal flap containing multiple vascular pedicles to decrease ...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.30359

    authors: Kubo T,Kurita T,Tashima H,Seike S,Fujii T,Yano M,Yamasaki M,Doki Y,Hosokawa K

    更新日期:2018-11-01 00:00:00

  • New model for simultaneous heart and kidney transplantation in mice.

    abstract::In clinical settings, combined heart and kidney transplantation results in a lower incidence of cardiac graft and renal graft rejection as compared to isolated heart and kidney transplantation. To study the phenomenon in an experimental setting, we developed a model of combined heart and kidney transplantation in mice...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.10111

    authors: Wang M,Bai J,Baumann M,Heemann U

    更新日期:2003-01-01 00:00:00

  • Late transplantation period of mice fetal intestine grafts: morphometric aspects.

    abstract::Morphometric evaluation of the fetal intestinal graft in the late post-transplant period was done by using C57BL/6 mice. Under anesthesia, after hysterotomy, a transversal laparotomy was done in the fetus to harvest all intestines. Grafts, cleaned from its mesentery, and divided were transplanted into the preperitoneu...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.20356

    authors: Saldanha De Almeida CE,Artigiani R,Ferreira De Oliveira K,Riboli Navarro PG,Montero EF

    更新日期:2007-01-01 00:00:00

  • Reconstruction of the foot with microvascular free flaps.

    abstract::Reconstruction of the foot using microvascular flaps has been widely performed in the last 15 years but the choice of flap to repair some areas in the foot remains controversial. We present a series of 128 free flaps to the foot performed during the period of 1975-1990. One hundred and seventeen had a successful outco...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.1920150110

    authors: Ferreira MC,Besteiro JM,Monteiro Júnior AA,Zumiotti A

    更新日期:1994-01-01 00:00:00

  • Intraoperative flap design using ICG monitoring of a conjoined fabricated anterolateral thigh/tensor fasciae latae perforator flap in a case of extensive soft tissue reconstruction at the lower extremity.

    abstract::In this report, we present a case of the use of a conjoined fabricated free anterolateral thigh (ALT)/tensor fascia latae (TFL) perforator flap for reconstruction of the lower extremity with intraoperative flap design using intraoperative indocyanine green (ICG) monitoring. The flap was used for reconstruction of a 16...

    journal_title:Microsurgery

    pub_type:

    doi:10.1002/micr.22424

    authors: Buehrer G,Taeger CD,Ludolph I,Horch RE,Beier JP

    更新日期:2016-11-01 00:00:00

  • Effect of torsion on microarterial anastomosis patency.

    abstract::All kinds of technical faults must be prevented in microvascular anastomosis for successful reconstructive microsurgery. Torsion at the anastomosis site is one of the most basic technical errors. In this study, we investigate the effect of different degrees of microarterial torsion on patency and its physical changes ...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.10092

    authors: Topalan M,Bilgin SS,Ip WY,Chow SP

    更新日期:2003-01-01 00:00:00

  • Transfer of brachialis branch of musculocutaneous nerve for finger flexion: anatomic study and case report.

    abstract::Based on an anatomic study, a transfer of the brachialis muscle branch of the musculocutaneous nerve (BMBMCN) to finger flexor functional fascicles of the median nerve was designed. Preliminary results of clinical application of this new procedure are reported. Dissection of 32 cadaver upper limbs revealed that BMBMCN...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.20053

    authors: Gu Y,Wang H,Zhang L,Zhang G,Zhao X,Chen L

    更新日期:2004-01-01 00:00:00

  • Reconstruction of a long defect of the ulnar artery and nerve with an arterialized neurovenous free flap in a teenager: A case report and literature review.

    abstract::There is evidence that nerve flaps are superior to nerve grafts for bridging long nerve defects. Moreover, arterialized neurovenous flaps (ANVFs) have multiple potential advantages over traditional nerve flaps in this context. This paper describes a case of reconstruction of a long defect of the ulnar artery and nerve...

    journal_title:Microsurgery

    pub_type: 杂志文章,评审

    doi:10.1002/micr.30265

    authors: Casal D,Pais D,Mota-Silva E,Pelliccia G,Iria I,Videira PA,Mendes MM,Goyri-O'Neill J,Mouzinho MM

    更新日期:2018-02-01 00:00:00

  • Regeneration across cold preserved peripheral nerve allografts.

    abstract::The feasibility of peripheral nerve allograft pretreatment utilizing cold storage (5 degrees C in the University of Wisconsin Cold Storage Solution) or freeze-thawing to prevent rejection was investigated. Regeneration across cold-stored (3 or 5 weeks) or freeze-thawed (FT), 3.0-cm sciatic nerve allografts were compar...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/(sici)1098-2752(1999)19:3<115::aid-micr1>3

    authors: Evans PJ,MacKinnon SE,Midha R,Wade JA,Hunter DA,Nakao Y,Hare GM

    更新日期:1999-01-01 00:00:00

  • Combined treatment of digital degloving injuries: a case report.

    abstract::In a digital degloving injury of four fingers, a combined treatment of tripedicle dermal flap, free hemipulp web flap, and skin graft was used. The functional and cosmetic results of the hand were satisfactory. The patient had an excellent sensory recovery in the free hemipulp web flap and did not complain of any disa...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/(sici)1098-2752(1998)18:3<172::aid-micr9>3

    authors: Karacalar A,Ozgenel Y,Ozcan M

    更新日期:1998-01-01 00:00:00

  • Objective preoperative estimation of the ability of primary closure on anterolateral thigh free flap donor site: circumference and area ratios of deep tissue to thigh.

    abstract:PURPOSE:The purpose of this study was to consider the relationship between the ratio of deep tissue including muscle to thigh at donor sites and the possibility of performing primary closure of donor site. METHODS:The subjects were 74 patients who had harvesting of anterolateral thigh (ALT) free flap from June 2005 to...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.22080

    authors: Song K,Nam S,Choi S,Kim J,Lee J,Bae Y

    更新日期:2013-05-01 00:00:00

  • Enhancement of peripheral nerve regeneration by pharmacological activation of the cyclic AMP second messenger system.

    abstract::This paper reviews the history of attempts to study peripheral nerve regeneration, focusing upon pharmacologic agents that may prove to be useful clinically. In particular, forskolin is described as a model for such an agent, and its mechanism of action, as a stimulator of the cyclic AMP second messenger system, is de...

    journal_title:Microsurgery

    pub_type: 杂志文章,评审

    doi:10.1002/micr.1920100211

    authors: Klein HW,Kilmer S,Carlsen RC

    更新日期:1989-01-01 00:00:00

  • The role of the anterolateral thigh flap in complex defects of the scalp and cranium.

    abstract::In this study, we introduced scalp reconstruction using free anterolateral thigh (ALT) flaps and evaluated postoperative outcomes in nine patients between March 2000 and April 2012. Five patients had problems of exposed prosthesis, three required reconstruction after resection of scalp tumor and one patient presented ...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.22103

    authors: Lin PY,Miguel R,Chew KY,Kuo YR,Yang JC

    更新日期:2014-01-01 00:00:00

  • Composite vascularized fibular epiphyseo-osteo-periosteal transfer for hip reconstruction after proximal femoral tumoral resection in a 4-year-old child.

    abstract::Literature on the reconstruction of the proximal femur in skeletally immature patients with the use of an epiphyseal transplant is scarce and with variable results depending on the indication. We report successful outcomes using a modified vascularized fibular epiphyseal transplant in a 4-year-old boy with an oncologi...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.21988

    authors: Soldado F,Fontecha CG,Haddad S,Corona P,Collado D,Llusá M,Rego P

    更新日期:2012-09-01 00:00:00

  • Aneurysmal cyst of the proximal radius: resection and free vascularized fibular bone graft.

    abstract::We present the case of a 22-year-old woman with an aneurysmal cyst of the right proximal radius, treated by resection and a free bone graft (microvascular fibular transfer), without recurrence after 4 years. Over a 4 month period, there was a rapidly expanding and lytic lesion found in the radius. There were symptoms ...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.1920140413

    authors: Nonnenmacher J,Bahm J,Laforest P,Kempf I

    更新日期:1993-01-01 00:00:00

  • The effect of supporting a surgeon's wrist on their hand tremor.

    abstract:BACKGROUND:Operative tremor can greatly influence the outcome of certain, precise, microsurgical operations. Reducing a surgeons tremor may not only improve the operative results but decrease the operative time. Previous studies have only measured uni or bi directional tremor and therefore have been unable to calculate...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.20776

    authors: Coulson CJ,Slack PS,Ma X

    更新日期:2010-10-01 00:00:00

  • Eight years experience in crush and avulsion type finger amputation.

    abstract::Between July 1986 and July 1994, we studied 125 total finger amputations due to crush and avulsion type injuries at the Izmir Hand and Microsurgery Hospital. Of the 125 fingers replanted, 88 were successful, for a general survival rate of 70.4%. In the period between 1986 and 1991, we performed end-to-end anastomoses ...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.1920161107

    authors: Ozerkan F,Ada S,Bora A,Kaplan I,Ademoglu Y

    更新日期:1995-01-01 00:00:00

  • Free flap failure due to venous occlusion secondary to previous intravenous cannulation: a case report.

    abstract::A case of failure of a free radial forearm flap is presented. It is surmised that this was due to venous thrombosis in the cephalic vein which showed evidence of recanalization of an old thrombus. The patient had received intravenous erythromycin some months previously. ...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.1920130613

    authors: Beckingham IJ,Wilson GR,McLean NR,Soames JV

    更新日期:1992-01-01 00:00:00

  • Management of osteonecrosis of the femoral head with pedicled iliac bone flap transfer: A multicenter study of 2190 patients.

    abstract:BACKGROUND:Osteonecrosis of the femoral head (ONFH) often affects young active adults and leads to destruction of the hip joint and disabling arthritis. Several procedures have been developed to arrest the progress of osteonecrosis and postpone the procedure of total hip replacement especially in young patients. The ai...

    journal_title:Microsurgery

    pub_type: 杂志文章,多中心研究

    doi:10.1002/micr.30195

    authors: Zhao D,Xie H,Xu Y,Wang Y,Yu A,Liu Y,Wang A,He W,Wang X,Li Z,Sun W,Tian S,Wang B,Liu B

    更新日期:2017-11-01 00:00:00

  • Microsurgical second dorsal metacarpal artery cutaneous and tenocutaneous flap for distal finger reconstruction: anatomic study and clinical application.

    abstract::In this paper, we report on the anatomical study of 34 cadaveric forearms with red latex injection and the clinical application of this study to 11 cases of microsurgical second dorsal metacarpal artery (SDMA) flaps. There were 8 cutaneous cases and 3 tenocutaneous cases using SDMA flaps for distal finger reconstructi...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.20077

    authors: Yu GR,Yuan F,Chang SM,Zhang F

    更新日期:2005-01-01 00:00:00

  • Experimental orthotopic small bowel transplantation: a revised model.

    abstract::Small bowel transplantation is emerging as an alternative treatment for end-stage intestinal failure. To date, immunological and technical problems are still hampering clinical success. Functional experimental small bowel transplantation models have traditionally been plagued with a high technical complication rate. T...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/(SICI)1098-2752(1996)17:7<409::AID-MICR11>

    authors: Scholten E,Werker PM,Green CJ,Kon M

    更新日期:1996-01-01 00:00:00

  • An innovative treatment concept for free flap reconstruction of complex central chest wall defects--the cephalic-thoraco-acromial (CTA) loop.

    abstract:BACKGROUND:Loco-regional flaps are the method of choice for chest wall reconstruction. However there is a selected group of patients who require free flap reconstruction, when all other options are used up. A small subgroup of these patients was identified where the commonly used recipient vessels (Internal mammary A. ...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.20391

    authors: Engel H,Pelzer M,Sauerbier M,Germann G,Heitmann C

    更新日期:2007-01-01 00:00:00

  • Experimental study of the relationship between alterations in tissue perfusion and anastomotic patency.

    abstract::It is generally believed that alterations in perfusion which endanger a free flap or replant are directly related to thrombus formation and obstruction of blood flow at the anastomotic site. Recent experimental work in our laboratory suggests that the presence of platelet emboli downstream in the microcirculation migh...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.1920140612

    authors: Barker JH,Anderson GL,Gu JM,Wyllie F,Acland RD

    更新日期:1993-01-01 00:00:00

  • Muscle fiber diameter and muscle type distribution following free microvascular muscle transfers: a prospective study.

    abstract::The histology of free microvascular muscle flaps in 19 patients was studied prospectively. Biopsies were taken during operation, and after 2 and 6 weeks, as well as 3, 6, and 9 months, postoperatively, fixed and stained using the van Gieson method. Fiber diameters were analyzed morphometrically and fiber types defined...

    journal_title:Microsurgery

    pub_type: 临床试验,杂志文章

    doi:10.1002/(sici)1098-2752(1998)18:2<137::aid-micr13>

    authors: Kauhanen MS,Salmi AM,von Boguslawsky EK,Leivo IV,Asko-Seljavaara SL

    更新日期:1998-01-01 00:00:00

  • Usefulness of microsurgery to isolation of recurrent laryngeal nerve and parathyroid during thyroidectomy operations.

    abstract::The authors report their experience of the application of microsurgical techniques in total and subtotal thyroidectomy operations from January 1984-January 1997. Four hundred and eighty-six patients with thyroid diseases were operated upon with both traditional and microsurgical techniques. The comparison of results s...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/(sici)1098-2752(1998)18:8<460::aid-micr6>3

    authors: Cavallaro G,Taranto G,Chiofalo MG,Cavallaro E

    更新日期:1998-01-01 00:00:00

  • Changes in arterial blood flow of free flaps after the administration of sildenafil in swine.

    abstract::We evaluated blood flow changes after experimental free tissue transfer and the potential hemodynamic effect of sildenafil on the free flap. Sixteen swine were used for free transfer of a latissimus dorsi myocutaneous flap to the chest that was anastomosed to the internal mammary vessels, and were randomized into cont...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.20909

    authors: Gravvanis A,Papalois A,Delikonstantinou I,Pentilas N,Zogogiannis I,Tsoutsos D,Karakitsos D

    更新日期:2011-09-01 00:00:00

  • Intraoral coverage of defects with the superficial epigastric fat flap in rats.

    abstract::The standard superficial epigastric artery flap has become a reliable model for flap research. The purpose of this study was to design a flap model in the rat, with the possibility of intraoral coverage of defects. A fat flap based only on the medial trunk of the superficial epigastric vessels was generated, raised to...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.20539

    authors: Mücke T,Hölzle F,Loeffelbein DJ,Haarmann S,Becker K,Wolff KD,Kesting MR

    更新日期:2008-01-01 00:00:00

  • Biomechanical assessment of fixation methods for segmental mandible reconstruction with fibula in the polyurethane model.

    abstract:BACKGROUND:A variety of plating techniques are employed by microsurgeons to provide rigid fixation for vascularized bone constructs of the mandible. The aim of this study was to biomechanically compare three commonly utilized plating techniques for rigid fixation of fibula bone flaps in reconstructing lateral segmental...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.30052

    authors: Fontana SC,Smith RB,Nazir N,Andrews BT

    更新日期:2016-05-01 00:00:00

  • Functional assessment of donor-site morbidity after harvest of a fibula chimeric flap with a sheet of soleus muscle for mandibular composite defect reconstruction.

    abstract::This study aims to compare donor-site morbidity between the traditional fibula osteocutaneous and chimeric fibula flaps for mandibular reconstruction. Twenty-three patients with head and neck cancer were recruited. Fifteen patients underwent the traditional fibula osteocutaneous flap. Eight patients received a chimeri...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.20955

    authors: Huang YC,Leong CP,Pong YP,Liu TY,Kuo YR

    更新日期:2012-01-01 00:00:00

  • The outcome of free tissue transfers in patients with hematological diseases: 20-year experiences in single microsurgical center.

    abstract:BACKGROUND:Free tissue transfers performed in patients with hematological diseases represent significant challenges for micro-surgeons. There are rare literatures that address the outcome in these patients. Therefore, we collected our database, analyzed the outcome, reliability, and related-management of microsurgical ...

    journal_title:Microsurgery

    pub_type: 杂志文章

    doi:10.1002/micr.22243

    authors: Lin PY,Cabrera R,Chew KY,Kuo YR

    更新日期:2014-10-01 00:00:00