Mousa-Doust Dorsa, Tran Khanh Linh, Bahat-Dinur Anat, Kwon Jamie Jae Young, Deane Emily C, Anderson Donald W, Durham J Scott, Prisman Eitan
Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
J Otolaryngol Head Neck Surg. 2025 Jan-Dec;54:19160216241307547. doi: 10.1177/19160216241307547.
The closure technique for the radial forearm free flap (RFFF), a commonly utilized flap in head and neck reconstruction, remains a debated topic as there are unique advantages and drawbacks to each technique.
The present study aims to report on the outcomes of the closure of the RFFF with the superficial cephalic vein (CV)-only system in terms of venous compromise and flap survival.
METHODS (DESIGN, SETTING, PARTICIPANTS, INTERVENTION, MEASURES): A retrospective review of patients who underwent head and neck reconstruction with RFFF between January 2015 and May 2021 at the authors' institution was performed. Cases were categorized as superficial, dual, and deep systems. Multiple population and operative variables were collected for the study group.
In total, 221 cases of RFFF were included, of which 169 (76.5%) cases were performed using the CV alone, whereas the remaining 52 (22.5%) cases utilized either the dual or the deep system alone. The operative time in the superficial group was 265 minutes. There were 9 venous complications in the CV group, of which 5 required re-exploration in the operating room and 4 were treated conservatively. All venous-related flap complications were salvaged.
A majority of the RFFF cases could successfully be completed using the CV as the sole venous drainage, with high rates of flap survival, low complications, and low operative time.
桡侧前臂游离皮瓣（RFFF）是头颈部重建中常用的皮瓣，其闭合技术仍是一个有争议的话题，因为每种技术都有独特的优缺点。
本研究旨在报告仅采用头静脉（CV）系统闭合RFFF的结果，包括静脉受压情况和皮瓣存活情况。
方法（设计、地点、参与者、干预措施、测量指标）：对2015年1月至2021年5月在作者所在机构接受RFFF头颈部重建的患者进行回顾性研究。病例分为浅静脉系统、双静脉系统和深静脉系统。收集研究组的多种人群和手术变量。
共纳入221例RFFF病例，其中169例（76.5%）仅采用CV进行手术，其余52例（22.5%）单独采用双静脉系统或深静脉系统。浅静脉系统组的手术时间为265分钟。CV组有9例静脉并发症，其中5例需要在手术室再次探查，4例采用保守治疗。所有与静脉相关的皮瓣并发症均得到挽救。
大多数RFFF病例可以成功地仅使用CV作为唯一的静脉引流完成，皮瓣存活率高，并发症少，手术时间短。
