Revisiting the argument for 1‐ versus 2‐vein outflow in head and neck free tissue transfers: A review of 317 microvascular reconstructions. Issue 6 (16th June 2015)

• Record Type: Journal Article
• Authors: Silverman, Dustin A.; Przylecki, Wojciech H.; Arganbright, Jill M.; Shnayder, Yelizaveta; Kakarala, Kiran; Nazir, Niaman; Tsue, Terance T.; Girod, Douglas A.; Andrews, Brian T.
• Is Part Of: Head & neck. Volume 38:Issue 6(2016)
• Page Start: 820
• Page End: 823
• Publication Date: 2015-06-16
• Subjects: free flap reconstruction -- venous congestion -- free tissue transfer -- vascular compromise -- dual vein outflow; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.23976
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: The purpose of this study was to determine the benefit of 1‐vein versus 2‐vein outflow in microvascular free tissue transfers. Methods: A retrospective review reflects the experience of 6 surgeons. Analysis included all patients who underwent reconstruction at a single institution between January 2004 and December 2012. Results: Three hundred nine patients underwent a total of 317 microvascular free flap reconstructions for head and neck defects. Two hundred thirteen of 317 flaps (67.2%) used 1 venous anastomosis and 104 (32.8%) used 2 venous anastomoses. Venous congestion necessitated urgent take back in 37 of 57 patients (64.9%) requiring exploration for perioperative complications. Thirty of 37 flaps (81.1%) with venous congestion had 1 vein anastomosis, whereas 7 (18.9%) had dual vein outflow ( p = .03). Overall flap success was 303 of 317 (95.6%), despite an 18.0% (57 of 317) perioperative take back rate. Conclusion: Coapting 2 veins was shown to minimize venous congestion. © 2015 Wiley Periodicals, Inc. Head Neck 38: 820–823, 2016