Availability of End-to-Side Arterial Anastomosis to the External Carotid Artery Using Short-Thread Double-Needle Microsuture in Free-Flap Transfer for Head and Neck Reconstruction

2006 ◽  
Vol 56 (2) ◽  
pp. 171-175 ◽  
Author(s):  
Mutsumi Okazaki ◽  
Hirotaka Asato ◽  
Shunji Sarukawa ◽  
Akihiko Takushima ◽  
Takashi Nakatsuka ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Head And Neck ◽  
Free Flap ◽  
External Carotid Artery ◽  
External Carotid ◽  
Head And Neck Reconstruction ◽  
Flap Transfer ◽  
Neck Reconstruction ◽  
Free Flap Transfer ◽  
Arterial Anastomosis

Free Flap Transfer for Head and Neck Reconstruction Using Local Anesthesia in Elderly Patients

2018 ◽  
Vol 80 ◽  
pp. S30-S35 ◽  
Author(s):  
Wan-Yu Hung ◽  
Cheng-Cheng Tung ◽  
Wan-Yun Fang ◽  
Wen-Pin Kao ◽  
Shih-Lung Lin ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Head And Neck ◽  
Local Anesthesia ◽  
Free Flap ◽  
Head And Neck Reconstruction ◽  
Flap Transfer ◽  
Neck Reconstruction ◽  
Free Flap Transfer

Free Flap Transfer for Pediatric Head and Neck Reconstruction: What Factors Influence Flap Survival?

2018 ◽  
Vol 129 (8) ◽  
pp. 1915-1921
Author(s):  
Shuo Liu ◽  
Wen-bo Zhang ◽  
Yao Yu ◽  
Yang Wang ◽  
Chi Mao ◽  
...  
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Head And Neck Reconstruction ◽  
Flap Survival ◽  
Flap Transfer ◽  
Neck Reconstruction ◽  
Free Flap Transfer

scholarly journals First Results of the Free Flap Transfer for the Head and Neck Reconstruction: The Public Hospital Experience

2012 ◽  
Vol 3 (2) ◽  
pp. 66-72
Author(s):  
Andrey Karpenko ◽  
Laslo Roman ◽  
Natalia Chumanikhina ◽  
Igor Kostyuk ◽  
Ramil Sibgatullin ◽  
...  
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Public Hospital ◽  
Head And Neck Reconstruction ◽  
Flap Transfer ◽  
The Public ◽  
Neck Reconstruction ◽  
Free Flap Transfer ◽  
First Results ◽  
Cause Of Failure

ABSTRACT The aim of the study is to assess our first results with the free flap transfer. Since October 2006 through April 2012, 58 operations were performed. The upper digestive tract was reconstructed in 46 cases, the soft tissues and skin of the head and neck region—in 12 cases. The primary plasty was performed in all but two cases. Eighteen first cases were performed with 2. 5 and 4x binocular loupes magnification only. The operating microscope was used in 40 cases. Fourty-two radial forearm fasciocutaneous flaps, five latissimus dorsi musculocutaneous flaps, nine anterolateral thigh flaps, one scapular osteocutaneous flap were used with the single case of the visceral flap— the jejunal flap. Death in early postoperative period occurred once. Complete flap loss occurred six times. Five radial and one latissimus dorsi free flaps were lost. The arterial thrombosis is considered as the primary cause of failure in one case, venous thrombosis—in two cases, postoperative infection—in one case with remaining two cases of the unknown primary cause of failure. There were three cases of the revision surgery with the attempts to reperform venous anastomosis, one of them was successful. The overall success rate in this series is 87.9%. Most of the failures occurred early in the series. The main cause of such a low rate of the success is a lack of experience. Even in a so small number of patients the results significantly improved from 72.2 to 94.4%. How to cite this article Karpenko A, Roman L, Chumanikhina N, Kostyuk I, Sibgatullin R, Belova E, Evdokimova N, Dzhalilov First Results of the Free Flap Transfer for the Head and Neck Reconstruction: The Public Hospital Experience. Int J Head Neck Surg 2012;3(2):66-72.

scholarly journals Microvascular free-flap transfer for head and neck reconstruction in elderly patients

BMC Surgery ◽  
2013 ◽  
Vol 13 (Suppl 2) ◽  
pp. S27 ◽  
Author(s):  
Francesco Turrà ◽  
Simone Padula ◽  
Sergio Razzano ◽  
Paola Bonavolontà ◽  
Gisella Nele ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Head And Neck ◽  
Free Flap ◽  
Head And Neck Reconstruction ◽  
Flap Transfer ◽  
Neck Reconstruction ◽  
Free Flap Transfer ◽  
Microvascular Free Flap

End-to-Side Venous Anastomosis to a Ligated Vein Stump for Free Flap Transfer in Head and Neck Reconstruction

2019 ◽  
Vol 83 (2) ◽  
pp. 180-182
Author(s):  
Toshifumi Akazawa ◽  
Mitsuru Sekido ◽  
Koji Adachi ◽  
Kaoru Sasaki ◽  
Yukiko Aihara ◽  
...  
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Head And Neck Reconstruction ◽  
Venous Anastomosis ◽  
Flap Transfer ◽  
Neck Reconstruction ◽  
Free Flap Transfer

scholarly journals Analysis of Fat Grafts for Stabilizing Microvascular Pedicle Geometry in Head and Neck Reconstruction

2017 ◽  
Vol 02 (02) ◽  
pp. e140-e144 ◽  
Author(s):  
Shunjiro Yagi ◽  
Yoshiko Suyama ◽  
Kohei Fukuoka ◽  
Maki Morita ◽  
Miki Kambe ◽  
...  
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Fat Graft ◽  
Head And Neck Reconstruction ◽  
Recipient Site ◽  
Flap Transfer ◽  
Neck Reconstruction ◽  
Fat Grafts ◽  
Free Flap Transfer ◽  
Postoperative Thrombosis

Background Even after careful microanastomosis, microsurgeons sometimes encounter unexpected twisting, kinking, and destabilizing mechanical forces. In these cases, a small fat graft is a useful technique for stabilizing the pedicle geometry in free flap transfer. However, few reports have provided the details with an analysis of fat graft use. The use of fat grafts for free flap transfer in head and neck reconstruction was reviewed. Materials and Methods This was a retrospective review of 157 patients (116 men, 41 women; average ± SD age: 64 ± 13.1 years) who had undergone head and neck reconstruction with free flap transfer between 2010 and 2016. We used a fat graft to stabilize pedicle geometry to prevent kinking and other problems. Postoperative thrombosis formation and the use of a fat graft at the pedicle depending on recipient vessel selection and reconstructed site were examined. Results In 23 patients (14.6%), fat grafting was performed to correct pedicle geometry. A fat graft was used at the arterial anastomosis in 13 patients and at the venous anastomosis in 10. There were no significant differences in postoperative thrombosis formation depending on the use of a fat graft. However, fat grafts were more likely to be performed with the superior thyroid artery as a recipient artery and in tongue and/or oral cavity reconstruction. Conclusion A fat graft is a reliable and easy procedure to correct pedicle geometry. However, reconstructive surgeons should consider the use of a fat graft based on the selection of the recipient vessels and the recipient site.

scholarly journals Outcome of Free-Flap Transfer for Head and Neck Reconstruction in Hypercoagulable Patients

2020 ◽  
Author(s):  
Wei Zhou ◽  
Wen-Bo Zhang ◽  
Yao Yu ◽  
Yang Wang ◽  
Chi Mao ◽  
...  
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Repeated Measures ◽  
Neck Region ◽  
Head And Neck Reconstruction ◽  
Head And Neck Region ◽  
Repeated Measures Anova ◽  
Flap Transfer ◽  
Flap Failure ◽  
Free Flap Transfer

Abstract Background: The purpose of this study was to examine the outcome and complications of hypercoagulable patients undergoing free-flap transfer in the head and neck region. Methods：We retrospectively reviewed the data of 685 consecutive free-flap transfers in the head and neck region performed by a single surgical team at the Peking University School and Hospital of Stomatology between January 2013 and December 2018. Based on preoperative coagulation indices the patients were separated into two groups: those with hypercoagulablity (group A, n = 45) and those with normal coagulation indices (group B, n = 640). Demographic characteristics, thrombosis and flap failure were compared between the two groups. Chi-square test and repeated-measures ANOVA were used for data comparisons.Results：Microvascular thrombosis rate (P = 0.42) and free-flap success rate (P = 0.38) were not significantly different between the groups. The platelet count and activated partial thromboplastin time changed significantly during the perioperative period in the hypercoagulable group (repeated-measures ANOVA, P < 0.001 for both).Conclusions：Hypercoagulability does not seem to increase risk of free-flap failure in head and neck microsurgery provided standard anticoagulation protocols are followed.

Recipient vessel selection for multiple free flap transfers in head and neck reconstruction at different periods

Microsurgery ◽  
2021 ◽  
Author(s):  
Chih‐Sheng Lai ◽  
Ching‐Hui Shen ◽  
Yi‐Ting Chang ◽  
Shih‐An Liu ◽  
Chen‐Te Lu ◽  
...  
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Head And Neck Reconstruction ◽  
Recipient Vessel ◽  
Neck Reconstruction ◽  
Selection For

scholarly journals Survival of a Free Jejunal Flap with Early Venous Obstruction

2021 ◽  
Vol 7 ◽  
pp. 2513826X2110224
Author(s):  
Ryo Yamochi ◽  
Toshiaki Numajiri ◽  
Syoko Tsujiko ◽  
Hiroko Nakamura ◽  
Daiki Morita ◽  
...  
Keyword(s):  
Head And Neck ◽  
Oral Intake ◽  
Superior Thyroid Artery ◽  
Head And Neck Reconstruction ◽  
Venous Obstruction ◽  
Flap Survival ◽  
Flap Transfer ◽  
Neck Reconstruction ◽  
Free Jejunal Flap ◽  
Vascular Status

Free jejunal flap transfer is common in head and neck reconstruction, but necrosis remains a complication. A 77-year-old man underwent total pharyngo-laryngo-esophagectomy, bilateral neck dissection, and free jejunal flap transfer. We anastomosed 3 arteries (facial, transverse cervical, and superior thyroid) and 1 vein (jejunal) because the recipient site’s arterial status was poor. On day 2, ultrasonography and visualization revealed that the anastomosed vein was obstructed in the cranial jejunum but the remainder was viable. The region recovered by day 7 and the patient began oral intake on day 30. Ultrasonography revealed that the anastomosed jejunal vein showed no waveform, the facial and transverse cervical arteries showed arterial waveforms, and the superior thyroid artery showed a retrograde venous waveform. The flap had survived because the blood exited through the superior thyroid artery and vein. Thus, additional vascular and arterial anastomoses are options for free flap survival if the vascular status is poor.

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