Revisiting the argument for 1- versus 2-vein outflow in head and neck free tissue transfers: A review of 317 microvascular reconstructions

Dustin A Silverman; Wojciech H Przylecki; Jill M Arganbright; Yelizaveta Shnayder; Kiran Kakarala; Niaman Nazir; Terance T Tsue; Douglas A Girod; Brian T Andrews

doi:10.1002/hed.23976

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Revisiting the argument for 1- versus 2-vein outflow in head and neck free tissue transfers: A review of 317 microvascular reconstructions

Journal article

Peer reviewed

Revisiting the argument for 1- versus 2-vein outflow in head and neck free tissue transfers: A review of 317 microvascular reconstructions

Dustin A Silverman, Wojciech H Przylecki, Jill M Arganbright, Yelizaveta Shnayder, Kiran Kakarala, Niaman Nazir, Terance T Tsue, Douglas A Girod and Brian T Andrews

Head & neck, Vol.38(6), pp.820-823

06/2016

DOI: 10.1002/hed.23976

PMID: 25546076

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Abstract

The purpose of this study was to determine the benefit of 1-vein versus 2-vein outflow in microvascular free tissue transfers. 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. 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. Coapting 2 veins was shown to minimize venous congestion. © 2015 Wiley Periodicals, Inc. Head Neck 38: 820-823, 2016.

Humans

Middle Aged

Veins - transplantation

Male

Free Tissue Flaps - blood supply

Young Adult

Neck - surgery

Adolescent

Aged, 80 and over

Microvessels

Adult

Female

Aged

Anastomosis, Surgical - methods

Hyperemia

Retrospective Studies

Child

Postoperative Complications

Reconstructive Surgical Procedures

Head - surgery

Details

Title: Subtitle: Revisiting the argument for 1- versus 2-vein outflow in head and neck free tissue transfers: A review of 317 microvascular reconstructions
Creators: Dustin A Silverman - Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, Kansas
Wojciech H Przylecki - Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, Kansas
Jill M Arganbright - Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas
Yelizaveta Shnayder - Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas
Kiran Kakarala - Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas
Niaman Nazir - Department of Preventive Medicine & Public Health, University of Kansas Medical Center, Kansas City, Kansas
Terance T Tsue - Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas
Douglas A Girod - Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas
Brian T Andrews - Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas
Resource Type: Journal article
Publication Details: Head & neck, Vol.38(6), pp.820-823
DOI: 10.1002/hed.23976
PMID: 25546076
NLM abbreviation: Head Neck
ISSN: 1043-3074
eISSN: 1097-0347
Language: English
Date published: 06/2016
Academic Unit: Craniofacial Anomalies Research Center; Neurosurgery; Otolaryngology
Record Identifier: 9984107393102771

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