The distally-based radial forearm free flap with valvulotomy of the cephalic vein; a preliminary report

Pederson, William C.; Eades, E.; Occhialini, Annette; Schuster, Jason; Demas, Christopher

doi:10.1016/0007-1226(90)90151-o

Cited by 8 publications

(2 citation statements)

References 6 publications

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“…In the pivoted reverse radial forearm island flap, edema and congestion occur f r e q u e n t~y ,~-'~~'~~~~*~~*~~ even more so when the venous return is provided by the comitantes veins only, especially when the pedicle is long.9,24,35 Some prefer a valvulotomised cephalic vein over the comitantes veins. 36 In our series of reversed radial free flaps, however, no edema was observed although in some cases the venous return safely depended on only one comitans vein in a long pedicle. The mechanism of reverse flow is poorly under-equate reverse flow through the comitantes veins.…”

Section: Discussionmentioning

confidence: 90%

”︁Impossible„ reversed radial forearm free flap in microsurgical reconstruction

Bauland¹,

Twisk²,

Bos³

et al. 1993

Microsurgery

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The reversed radial forearm free flap is described and patient histories are presented to illustrate its unique reconstructive versatility. The valvular orientation of the deep and superficial forearm veins should theoretically oppose the reversed flow in this flap, but the venous flow is not compromised. In comparison to the anterograde forearm free flap the vascular pedicle is longer and the donor defect generates less functional and cosmetic complications because it is located on the proximal forearm. In a review of the literature anatomical details of the venous drainage are presented. Different opinions on reverse flow in forearm flaps are discussed and a new theory is proposed.

show abstract

Section: Discussionmentioning

confidence: 90%

”︁Impossible„ reversed radial forearm free flap in microsurgical reconstruction

Bauland¹,

Twisk²,

Bos³

et al. 1993

Microsurgery

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show abstract

“…Within each type of flap, either an artery (a) or a vein (b) that functions as an artery (arterialized vein) 50,51 can be used to provide perfusion to distal tissues. 44,45 Forearm reconstruction (after sarcoma resection), 21 hand reconstruction, 46 digital reconstruction 47 , digital…”

mentioning

confidence: 99%

Flow-through flaps: A review of current knowledge and a novel classification system

et al. 2006

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Flaps have long been recognized as an essential tool for soft-tissue reconstruction. Flaps range in complexity from local to free and perforator flaps and can include a variety of composite tissues. The concept of a flow-through flap, in which both the proximal and the distal ends of the vascular pedicle of a free flap are anastamosed to provide blood flow to distal tissues, was first described by Soutar et al. in 1983. An uninterrupted arterial flow was established by Soutar et al. between the external carotid and distal facial artery via a radial forearm flap for head and neck reconstruction (Soutar et al., Br J Plast Surg 1983;36:1-8). Shortly thereafter, Foucher et al. were the first to report the reconstruction of an extremity with a simultaneous vascular defect by utilizing a radial forearm flow-through flap (Foucher et al., Br J Plast Surg 1984;37:139-148). The utility of the flow-through flap is now well established, and its indications for use continue to grow. The principle advantage of this flap is that it provides the opportunity for a single stage composite reconstruction of both soft tissue and vascular defects, making it particularly useful in the reconstruction of ischemic extremities and defects from oncologic ablations. Improvements in microsurgical equipment and techniques are making early difficulties with these flaps irrelevant, giving plastic surgeons opportunities to become more creative in the choices and uses of flow-through flaps. The literature consists mostly of case reports and series. The nomenclature used to describe the types of flow-through flaps is confusing and inconsistent. The purpose of this article is to provide an organized review of flow-through flaps and to classify these flaps based on their inflow, outflow, and the nature of their vascular conduit. Additionally, we have included a discussion on the physiology of these flaps, reviewed the current literature, and summarized the various types of flow-through flaps in a reference guide that can aid in flap selection.

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The cephalic vein in microsurgery

Hallock¹

1993

Microsurgery

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A working knowledge of the venous anatomy is seldom emphasized but is an essential element in all microvascular procedures. The cephalic vein has been chosen here to serve as a model, since it is an important source for both afferent and efferent flow for flap transfers as well as in limb replantations. The better known, lower extremity superficial veins, especially as a source for long vein grafts, are not necessarily the best option. The cephalic vein represents the most versatile of the large superficial veins of the upper extremity and has numerous roles in microsurgery other than as a viable alternative for vein grafts.

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The distally-based radial forearm free flap with valvulotomy of the cephalic vein; a preliminary report

Cited by 8 publications

References 6 publications

”︁Impossible„ reversed radial forearm free flap in microsurgical reconstruction

”︁Impossible„ reversed radial forearm free flap in microsurgical reconstruction

Flow-through flaps: A review of current knowledge and a novel classification system

The cephalic vein in microsurgery

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