Outcomes following head neck free flap reconstruction requiring interposition vein graft or vascular bridge flap.
Research article published in Head & neck (2019)
Abstract
BACKGROUND: Interposition vein grafts (IVG) and vascular bridge flaps (VBF) have been exploited as vascular conduit in challenging head and neck reconstructions. METHODS: A retrospective review was conducted on 6025 flaps. The effect of patients' characteristics and length of IVG on flap compromise and loss were analyzed. Comparison between IVG and VBF was performed. RESULTS: The flap compromise and loss rates for the overall group were 8.2% and 3.2%, respectively. An IVG was used in 309 free flaps. The average length of the vein grafts was 6.9 ± 4.2 cm. An unplanned return to the operation room occurred in 32 cases (10.4%) and failure of the flap in 12 patients (3.9%). Binary logistic regression found a significant association between flap compromise and loss rates and length of IVG, hypertension, prior radiation, and neck dissection. In the multiple regression model, length of IVG and prior radiation significantly influenced the outcomes. Thirty-nine patients underwent reconstruction with a long IVG (>10 cm). Twenty-six patients underwent surgical reconstruction with radial forearm flap as a VBF. The rate of flap compromise was higher in the group with a long IVG (P = .01). CONCLUSIONS: In head and neck free flap reconstruction, the length of IVGs and history of radiotherapy are associated with flap compromise and loss. In case of long distance between the pedicle and the recipient site, the use of a VBF bridge should be considered as a safe alternative.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Interposition vein grafts (IVG) and vascular bridge flaps (VBF) have been exploited as vascular conduit in challenging head and neck reconstructions. A retrospective review was conducted on 6025 flaps.
Por qué esto importa para la hirudoterapia
Esta amplia revisión retrospectiva de 6.025 colgajos libres de cabeza y cuello analizó los factores de riesgo para el compromiso y la pérdida del colgajo, encontrando que los injertos venosos de interposición más largos (>10 cm) y la radioterapia previa se asociaron de forma significativa con peores resultados. Los autores recomiendan los colgajos puente vasculares como una alternativa más segura para reconstrucciones de larga distancia. Para la ASH, existe un vínculo contextual indirecto: la terapia con sanguijuelas se emplea a veces en el rescate de colgajos por congestión venosa, una complicación relevante para los resultados de compromiso del colgajo discutidos. Sin embargo, el resumen no menciona sanguijuelas, hirudoterapia ni el uso de sanguijuelas medicinales. SALVEDAD: no existe contenido relacionado directamente con sanguijuelas en este resumen; cualquier relevancia para la ASH es especulativa y se limita al contexto quirúrgico general en el que la terapia con sanguijuelas puede asistir adyuvante a la supervivencia del colgajo.
Citación
Outcomes following head neck free flap reconstruction requiring interposition vein graft or vascular bridge flap.
Di Taranto et al. · Head & neck, 2019
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: June 18, 2026