Cephalic Vein-Pedicled Radial Forearm Semi-free Flap: An Alternative When no Suitable Vein in Recipient Site for Free Forearm Flap

Abstract

The risk of venous thrombosis is the main factor of free forearm flap necrosis. In some cases there is no suitable vein at recipient site to provide venous return of the free flap. In this report, two cephalic vein-pedicled radial forearm semi-free flaps were used as an alternative to resurface soft tissue defects in submaxilla and anterior cervical area. The two flaps survived uneventfully. The cephalic vein-pedicled radial forearm semi-free flap could be harvested with a long cephalic vein pedicle, and could be an alternative when there was no suitable or healthy recipient veins at recipient site.

Keywords

Cephalic vein - Radial forearm flap - Reconstruction

• References

• 1 Hanasono MM, Bamea Y, Skoracki RJ. Microvascular surgery in the previously operated and irradiated neck. Microsurgery 2009; 29 (1) 1-7
• 2 Nakayama Y, Soeda S, Lino T. A radial forearm flap based on an extended dissection of cephalic vein: the longest venous pedicle?. Br J Plast Surg 1986; 39 (4) 454-457
• 3 Zapater E, Simón E, Ferrandis E, Vendrell JB. Radial free flap with drainage through the cephalic vein dissected up to the deltoid region: a resource in the absence of receptor veins. Acta Otorrinolaringol Esp 2001; 52 (7) 617-620
• 4 Quilichini J, Benjoar MD, Hivelin M et al Semi-free radial forearm flap for head and neck reconstruction in vessel-depleted neck after radiotherapy or radical neck dissection. Microsurgery 2012; 32 (4) 269-274
• 5 Pierrel C, Bodin F, Schultz P et al Semi-free forearm flap for pharyngeal-esophageal reconstruction after radiation therapy. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132 (2) 101-103
• 6 Bénateau H, Crasson F, Bencheman Y et al Contribution of the semi-free radial forearm flap for head and neck reconstruction. Rev Stomatol Chir Maxillofac 2002; 103 (2) 74-78
• 7 Soutar DS, McGregor IA. The radial forearm flap in intraoral reconstruction: the experience of 60 consecutive cases. Plast Reconstr Surg 1986; 78 (1) 1-8
• 8 Krag C, De Rose G, Lyczakowski T et al Free flaps and irradiated recipient vessels: an experimental study in rabbits. Br J Plast Surg 1982; 35 (3) 328-336
• 9 Joe SA, Brown MT, Couch ME. Microvascular free tissue transfer failure: the effects of radiation and chemotherapy. Fifth research workshop on biology, prevention and treatment of head and neck cancer. Head Neck 1998; 20 (5) 458
• 10 To EW, Wang JC. Radial forearm free flap: hybrid version. Plast Reconstr Surg 1999; 104 (4) 1066-1069
• 11 Kim KA, Chandrasekhar BS. Cephalic vein in salvage microsurgical reconstruction in the head and neck. Br J Plast Surg 1998; 51 (1) 2-7
• 12 Vasilakis V, Patel HD, Chen HC. Head and neck reconstruction using cephalic vein transposition in the vessel-depleted neck. Microsurgery 2009; 29 (8) 598-602
• 13 Barnett GR, Carlisle IR, Gianoutsos MP. The cephalic vein: an aid in free TRAM flap breast reconstruction. Report of 12 cases. Plast Reconstr Surg 1996; 97 (1) 77-78
• 14 Safak T, Akyürek M. Cephalic vein-pedicled arterialized anteromedial arm venous flap for head and neck reconstruction. Ann Plast Surg 2001; 47 (4) 446-449
• 15 Klein C, Kovacs A, Stuckensen T. Free arterialized venous forearm flaps for intraoral reconstruction. Br J Plast Surg 1997; 50 (3) 166-171
• 16 Kovacs AF. Comparison of two types of arterialized venous forearm flaps for oral reconstruction and proposal of a reliable procedure. J Craniomaxillofac Surg 1998; 26 (4) 249-254