title: Reliability of venous couplers for microanastomosis of the venae comitantes in free radial forearm flaps for head and neck reconstruction.
abstract: The radial forearm free flap has gained popularity in head and neck reconstruction after oncologic resection because of its versatility. This popularity has only intensified with the advances in technique and instrumentation. Although debated in the past, the success of using the deep venae comitantes system for flap drainage is well documented. Although the use of couplers in a variety of flap anastomoses has been described in the literature, to our knowledge this is the first series presented on the use of couplers in small, deep system venae comitantes. We retrospectively examined our experience in 61 patients who underwent radial forearm free flaps for head and neck reconstruction. Of the 61 patients, 22 anastomoses were hand sewn, and 39 anastomoses were performed using venous couplers. No flap losses occurred in the group in whom venous couplers were used. In addition, no intraoperative thromboses, arterial or venous, were noted with coupler use. Our series demonstrates that the venous coupler is a safe and effective alternative to the hand-sewn anastomosis of the radial forearm free flap venous comitantes in head and neck reconstruction.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19046, USA. sameer.patel@fccc.edu
authors.forename: Sameer A
authors.initials: SA
authors.lastname: Patel
authors.forename: John Henry
authors.initials: JH
authors.lastname: Pang
authors.forename: Noel
authors.initials: N
authors.lastname: Natoli
authors.forename: Sidhbh
authors.initials: S
authors.lastname: Gallagher
authors.forename: Neal
authors.initials: N
authors.lastname: Topham
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D004322:Drainage / Q000379:methods; D005260:Female; D005542:Forearm / Q000098:blood supply*; D058752:Free Tissue Flaps / Q000098:blood supply; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D017534:Radial Artery / Q000503:physiopathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome; D014680:Veins