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European Journal of Oral and Maxillofacial Surgery 2019 April;3(1):7-11

DOI: 10.23736/S2532-3466.18.00156-X

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Surgical outcomes of radial forearm free flap surgeries performed by trainee surgeons

Zahid QAYYUM 1 , Nadeena JAYASURIA 2, Manjula ATTYGALLA 2

1 Hayatabad Medical Complex Peshawar, Hayatabad Peshawar, Pakistan; 2 Peradeniya University, Kandy, Sri Lanka



BACKGROUND: Radial forearm free flap (RFFF) is reliable microvascular flap in head and neck reconstructions with success ranging from 89.5-100%. However, the outcomes, complications and difficulties faced by trainee surgeons new to RFFF surgeries is not described in literature.
METHODS: Nineteen RFFF surgeries were performed over nine months on patients diagnosed with oral cancer were analysed. Surgeries were performed by two oral and maxillofacial surgeons who were new to microvascular surgery who had training in microsurgical techniques. Cheek, lateral tongue and lip were the common sites reconstructed. Facial artery and common facial vein were the most common recipient vessels. Cephalic vein was the sole vein anastomosed in eleven cases.
RESULTS: Total flap failure occurred in two patients (10.5%) due to venous congestion after fifth postoperative day. Re-exploration was done in five (26.3%) cases during the first 48 hours. Vein crisis was the most frequent complication (21.1%) followed by hematoma formation (10.5%).
CONCLUSIONS: The overall complication rate was slightly higher in this study compared to literature. Poor patient selection was a key factor in failures. Cephalic vein had a reliable diameter for easy anastomosis and when used alone, maintained an adequate venous drainage. RFFF is a good flap to start training in microvascular surgery.


KEY WORDS: Forearm - Free tissue flaps - Surgery

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