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J Reconstr Microsurg 2003; 19(6): 371-376
DOI: 10.1055/s-2003-42631
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Fail-Safe Drainage Procedure in Free Radial Forearm Flap Transfer

Akihiro Ichinose1 , Shinya Tahara1 , Satoshi Yokoo2 , Makoto Omori1 , Suguru Miyamura1 , Yori Tsuji1 , Kenich Nibu3 , Miki Saito3
  • 1Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
  • 2Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
  • 3Department of Otorhinolaryngology, Kobe University Graduate School of Medicine, Kobe, Japan
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Publication History

Publication Date:
29 September 2003 (online)

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ABSTRACT

The reliability of the free radial forearm flap is widely accepted; however, postoperative venous thrombosis still occurs occasionally. Thus, establishment of a fail-safe drainage system has been a challenging frontier. A total of 405 consecutive free radial forearm flap transfers, carried out in the authors' department between 1987 to 2002, were reviewed retrospectively. The most reliable drainage method comprised the dual flap drainage veins of the superficial venous system (the cutaneous vein) and the deep system (the radial vena comitans), including their connecting cubital perforating vein, and the two neck recipient veins of the internal jugular and the external jugular venous systems. None of the flaps transferred by this method incurred venous failure, regardless of the surgeons conducting the operation. This study on the venous network in drainage systems of the free radial forearm flap demonstrated that the described method functions in a self-sustaining manner, and contributes to protection against venous catastrophe.

KEYWORDS

Free radial forearm flap - drainage - cutaneous vein - radial venae comitantes - perforating vein - recipient vein

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