Abstract:
BACKGROUND: Various reports suggest the augmentation of venous drainage through performing two venous anastomoses as a means of reducing the rate of thrombosis in free flap surgery. However, some suggest dual venous drainage may actually reduce venous blood flow velocity causing a potential risk for thrombosis. METHODS: On the basis of the Preferred Reporting Items for Systematics Reviews and Meta-analysis statement, a systematic search was conducted using PubMed and Medline databases. A total of 12,190 articles relating to "free flaps" and "one versus two venous anastomoses" were found between January 1992 and November 2012. Of the 12,190 articles, 23 studies were included in a meta-analysis performed using STATA 11.2 (StrataCorp, College Station, TX). Studies with case control groups for both single and double venous anastomoses and clearly defined results for flap failure and venous thrombosis were included. 95% confidence interval (CI) were calculated for each study and pooled in both fixed and random-effects models for both flap failure and venous thrombosis events. RESULTS: The analysis shows a significant reduction in flap failure (risk ratio, 0.64; 95% CI, 0.41-0.99; p = 0.03) and venous thrombosis (risk ratio, 0.66; 95% CI, 0.46-0.97; p = 0.047) when performing two venous anastomoses compared with one in free flap surgery. CONCLUSION: The results show that performing two venous anastomoses is associated with a reduction in the incidence of flap failure by 36% and venous thrombosis by 34% compared with one venous anastomoses. Given that the performing of an additional venous anastomoses confers a lower risk of complication and is technically feasible, where possible two venous anastomoses should be performed in free flap procedures, however, this should be decided on a flap by flap basis.
journal_name
J Reconstr Microsurgjournal_title
Journal of reconstructive microsurgeryauthors
Ahmadi I,Herle P,Rozen WM,Leong Jdoi
10.1055/s-0034-1372368subject
Has Abstractpub_date
2014-07-01 00:00:00pages
413-8issue
6eissn
0743-684Xissn
1098-8947journal_volume
30pub_type
杂志文章,meta分析,评审abstract::Greater than 80 percent of free flap thromboses have been shown to occur within the first three postoperative days, warranting immediate re-exploration and restoration of adequate vessel patency. The infrequency of thromboses beyond this period is reflected in the lack of reported cases in the literature and the absen...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2002-35095
更新日期:2002-10-01 00:00:00
abstract::This study investigated the effect of crush duration at different loads on motor functional recovery. One hundred and thirty-eight rats were divided into five groups: sham operation, resected sciatic nerve, and 100 g, 500 g, and 15,000 g of sciatic crush load (Groups 1 to 5). According to crush duration, Groups 3 and ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006671
更新日期:1993-07-01 00:00:00
abstract::The authors recently reported an experimental study on diode laser-assisted microvascular anastomosis (LAMA) in the femoral arteries and veins of rats. Good success rates and very promising histologic results obtained in this preliminary phase suggested an extension of the investigation with a larger number of rats an...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006405
更新日期:1997-04-01 00:00:00
abstract::The use of frozen section histological analysis in primary obstetrical brachial plexus palsy reconstruction, though widespread, is not universally practiced. Our objective was to develop a histological grading scale that could be used to determine whether further resection of a microscopically suboptimal, though gross...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2008-1076756
更新日期:2008-04-01 00:00:00
abstract::From 1991 to 1996, four free vascularized fibular grafts (FVFG) and four callus distraction (CD) techniques were performed for post-traumatic tibial defects at the authors' institute. They attempted to discern any differences of results between FVFGs and CDs for post-traumatic tibial defects. The mean defect length of...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2001-12684
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:The authors presented their clinical experience and demonstrated surgical methods for reconstructing complex bone and soft tissue defects of the hand by using modified chimeric radial collateral artery perforator flaps. METHODS:Surgical procedures that employed 16 modified chimeric radial collateral artery ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0034-1390324
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Open injuries of the Achilles tendon, which can be complicated by skin and bone injuries, continue to be a great challenge for surgeons. This study aims to report our experience with treatment of open Achilles tendon defects, focusing on the injury mechanisms, soft tissue coverage and late complications. ME...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0033-1358787
更新日期:2014-10-01 00:00:00
abstract::Sixteen rats underwent two procedures to test the efficacy of oblique vs. transverse nerve repair. On the left, the peroneal nerve was transected at an oblique angle (30-degree) with subsequent oblique end-to-end repair performed. On the right, the peroneal nerve was transected at a transverse angle (90-degree) with s...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2002-36503
更新日期:2002-11-01 00:00:00
abstract::Composite tissue transplantation has emerged as a viable alternative to prosthetics and complex reconstructive surgery. Thus far it is reserved for cases which cannot be effectively reconstructed and where it offers some benefits over prostheses. It has been used in the upper extremity with encouraging results and, mo...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2006-939928
更新日期:2006-05-01 00:00:00
abstract::Regardless of its type, the repair of a peripheral nerve must ideally permit early motion of the affected limb and resist disruption by the tensile forces generated throughout the healing process and regeneration. A comparative study of the mechanical resistance of the repair of the sciatic nerve with biological glue ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2008-1080535
更新日期:2008-07-01 00:00:00
abstract::Free flaps are usually needed for the reconstruction of extensive facial burns, but the final result is often a poor texture and color match. The authors report a burn case managed with a radial forearm free flap. The aesthetic result was improved by surgical tattooing of the flap, including the appearance of a beard....
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006739
更新日期:1993-09-01 00:00:00
abstract::Patients undergoing free tissue transfer are particularly susceptible to hypothermia. The goal was to investigate the impact of intraoperative core body temperature on free flap thrombosis. Two hundred twelve cases of free flap reconstruction at Yale-New Haven Hospital between 1992 and 2008 were reviewed. Free flap th...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0030-1268211
更新日期:2011-02-01 00:00:00
abstract::Local anesthetic drugs with prolonged nerve-block effect would have clinical application for postoperative or neuromatous pain relief. This study evaluated the possibility of peripheral nerve neurotoxicity by injection of 10 percent ammonium sulfate. Both intrafascicular and extrafascicular injection of 10 percent amm...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006418
更新日期:1997-08-01 00:00:00
abstract::Eleven patients with paralysis of muscle groups in the upper or lower extremity were clinically diagnosed after previous proximal direct trauma to the corresponding peripheral nerves, without complete nerve disruption. Patients were seen within an average of 8 months after trauma (minimum 3 months and maximum 2 years ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000087
更新日期:1999-04-01 00:00:00
abstract::Nerve transection using rat sciatic nerves was employed to observe morphologic changes in the periodic denervation of Pacinian corpuscles. During periods of from 1 to 20 weeks after surgery, a total of 15 corpuscles were obtained under the operating microscope and processed for morphologic analysis using light and ele...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000101
更新日期:1999-05-01 00:00:00
abstract::The etiopathology, clinical features, and treatment of carpal tunnel syndrome (CTS) in long-term hemodialyzed patients, are discussed in the light of new clinical findings. Conclusions summarizing the specific characteristics of CTS in hemodialyzed patients include the following. 1) There is a relatively equal sex rat...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006856
更新日期:1989-04-01 00:00:00
abstract::The use of growth factors in inducing angiogenesis and enhancing flap viability has provided promising results. Targeted gene therapy has evolved in hopes of increasing the longevity and effectiveness of these growth factor treatments. The purpose of this study was to examine the effect of preoperative treatment by va...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2005-915207
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND: Investigating correlations between clinical, instrumental, and genetic features of primary lymphedema (PL) with the aim to facilitate the diagnosis, the staging, and the management of this subgroup of patients. METHODS: A prospective observational study was conducted from September 2016 to May 2018, includ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0039-1698748
更新日期:2020-03-01 00:00:00
abstract::The subject of ischemia-reperfusion has commonly been studied in rat hindlimb models. Unfortunately, in these experiments, the ischemia procedures lack standardization. For this reason, the authors evaluated the reliability of rat ischemia models described in the literature using scintigraphy. The study comprised six ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2004-830005
更新日期:2004-07-01 00:00:00
abstract::During the last seven years, 17 patients underwent microsurgical reconstruction of 14 hepatic and four superior mesenteric arterial systems following extended pancreatectomy or hepatectomy, and in living-related liver transplantations (LRLT). All microvascular anastomoses in this series were performed using a back wal...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000109
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND: The distal lower extremity poses unique reconstructive challenges due to its requirements for durability of the load-bearing plantar surface and for thin, pliable contour in the dorsal foot and ankle region. This study compares outcomes between muscle and fasciocutaneous flaps in patients with foot and ankl...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0039-1691785
更新日期:2019-11-01 00:00:00
abstract::An experimental study in rats was designed to determine the effects of z-plasty on the patency of microvascular anastomosis. Eighty Sprague-Dawley rats of mixed sex were divided into two groups. In all animals, the left carotid arteries were used. In the first group (n = 40), a single z-plasty was done at the anterior...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000153
更新日期:1998-02-01 00:00:00
abstract::Facial wounds are frequently associated with bone fractures and multiple trauma; however, disruption of the parotid gland or Stensen's duct is rare and is often associated with facial nerve palsy. Lesions are often undiagnosed on first assessment of the multiple trauma patient. If microsurgical repair of Stensen's duc...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000078
更新日期:1999-02-01 00:00:00
abstract::This study attempted to re-establish vascularization to canine allograft bone by means of the introduction of a pedicle in the medullary canal with a capillary network. The experiment showed basically that the introduction of arteries and veins with a capillary network into the medullary canal of an allograft femur pr...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006767
更新日期:1991-04-01 00:00:00
abstract:BACKGROUND: Replantation of a single digit at the distal phalanx level is not routinely performed since it is technically challenging with questionable cost-effectiveness. The purpose of this study was to analyze international microsurgeons' clinical decisions when faced with this common scenario. METHODS: A survey of...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0039-1701013
更新日期:2020-05-01 00:00:00
abstract::Multiple level amputation has been described as a contraindication to replantation. This is a case report of a patient with a double level amputation through the palm and forearm that was successfully replanted. Because of the need for multiple stages of reconstructive surgery, it was not clear until the end result th...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1007016
更新日期:1986-04-01 00:00:00
abstract::When faced with venous insufficiency following replantation or free-tissue transfer, the surgeons' first choice is surgical repair. When repair is not possible, medicinal leeches may be applied to relieve congestion. However, leeches increase the possibility of infection through their gut contents, and there are times...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006511
更新日期:1995-01-01 00:00:00
abstract::Findings reported in the literature on the sensation provided by intraorally applied innervated vs. non-innervated radial forearm free flaps differ. In an effort to understand these differences in sensory recovery, the authors carried out sensory evaluations in 12 patients who had undergone radial forearm free flaps. ...
journal_title:Journal of reconstructive microsurgery
pub_type: 临床试验,杂志文章
doi:10.1055/s-2000-7549
更新日期:2000-04-01 00:00:00
abstract::Multilayered tubes fabricated from human amnion were placed subcutaneously and/or longitudinally in contact with an axial artery and vein in rats. Histologic evaluation at the third postoperative week showed that the tubes had incorporated with the surrounding fibrovascular tissue. New capillary formation within the t...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006749
更新日期:1993-11-01 00:00:00
abstract::The regions of the body have cortical and subcortical representation in proportion to their degree of innervation. The rat forepaw has been studied extensively in recent years using functional magnetic resonance imaging (fMRI), typically by stimulation using electrodes directly inserted into the skin of the forepaw. H...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0028-1088231
更新日期:2008-11-01 00:00:00