Distal facial vein catheterization for prevention and management of thrombosis in vascularized lymph node transfers

Abstract

Background: This study investigated the outcomes of the distal facial vein catheterization (DFVC) to manage venous thrombosis in vascularized submental lymph nodes (VSLN) flap transplantations. Methods: Between March 2017 and December 2020, patients who underwent VSLN flaps were divided into Group I: combined delayed primary retention sutures (DPRS) with DFVC, and Group II: DPRS alone. Primary outcomes were early (within 72 h) and late venous thrombosis. Secondary outcomes included other nonvascular complications and mechanical factors of the thrombosis.Results: A total of 105 patients who underwent 106 VSLN flaps, including 37 and 69 flaps in Groups I and II, respectively, were included. There were no statistically significant differences in age, body mass index, Taiwan lymphoscintigraphy staging, and surgical factors between the two groups (all p > 0.05). Early venous thrombosis requiring re-exploration developed in one (2.7%) and three (4.3%) flaps in Groups I and II, respectively (p = 0.20). One flap (2.7%) and eight (11.5%) flaps developed late venous thrombosis in Groups I and II, respectively (p < 0.01). There was no statistically significant difference in total complication rates between both groups (p = 0.9). Conclusion: VSLN flap transplantation had a significantly higher risk of late venous thrombosis. DFVC significantly decreased the late venous thrombosis. K E Y W O R D S free tissue transfer, lymphedema, venous thrombosis, VLNT 1 | INTRODUCTION Extremity lymphedema is a chronic and progressive disease that can immensely hamper a patient's functionality and quality of life.

Safety and efficacy of intracranial vascularized submental lymph node transfer for treating hydrocephalus

“…18 A catheter was placed in the distal facial vein for continuous irrigation which has been shown to significantly reduce the incidence of venous thrombosis. 19…”

“…The VSLN flap skin paddles were inset into the frontotemporal scalp with a series of delayed primary retention sutures, which relieved pressure on the transplanted flap, allowed access to the pedicle for direct assessment of patency, and significantly improved re‐exploration and complication rates 18 . A catheter was placed in the distal facial vein for continuous irrigation which has been shown to significantly reduce the incidence of venous thrombosis 19 …”