Proper Choice of Donor Site Veins for Patients Undergoing Free Radial Forearm Flap Reconstruction for the Defects of Head and Neck

Publication date: Available online 3 August 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Zhai Qin-kai, Dai Wei, Tan Xue-xin, Sun Jian, Zhang Chen-ping, Qin Xing-jun
BackgroundThe purpose of this study was to analyze the reliability of the deep venous drainage system of the free radial forearm flap.MethodsThe authors implemented a retrospective cohort study and enrolled patients admitted for the evaluation and management of head and neck tumors with radial forearm flap reconstruction. The primary predictor variables were defined as the donor site veins including the deep, dual, and superficial venous drainage systems. The primary outcome measure was defined as the incidence of venous compromise. Potential confounders included patient demographics, history of chemotherapy and/or radiotherapy, defect sites, and the recipient artery and vein. The chi-square test and logistic regression analysis were used for statistical analysis.ResultsThe final study population comprised 520 subjects (mean age, 54 years), who underwent free radial forearm flap for head and neck soft tissue reconstruction. Patients with the deep system (odds ratio [OR]: 0.251, 95% confidence interval [CI]: 0.108–0.581) or dual system (OR: 0.197, 95% CI: 0.064–0.605) had a significantly lower risk of venous compromise than those with the superficial system. The overall incidence of inadequate outflow was 2.5% (5/204) when the deep system was used alone, and 8.9% (19/212) when the superficial system was used alone (P = 0.004).ConclusionsPatients with the deep venous drainage system had a significantly lower risk of venous compromise. This study recommends using the deep system as a drainage vein for the free radial forearm flap.



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