Versatility of radial artery fascio-cutaneous free flap for head and neck reconstruction
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Keywords
radial artery free flap, microsurgery, Allen test, head and neck
Abstract
Background: Reconstruction of the head and neck has made significant progress with the advent of microsurgery. The radial artery free flap is a workhorse flap in head and neck reconstruction due to its high-quality tissue that conforms to the complex and vital structures in this region. Aim: This study aims to assess the versatility and pliability of the radial artery free flap in the reconstruction of head and neck defects. Methods: A retrospective study was conducted over a six-year period (2017 to 2022) in Erbil, the capital of the Kurdistan region in Iraq, at Maryamana and PAR private hospitals. Twelve patients were included in the study, all of whom presented with large soft tissue losses and defects exposing vital structures in the head and neck The Allen test was performed bilaterally to assure perfusion. The operations were carried out under general anesthesia, and patients stayed in the hospital for seven days post-operation. Antiplatelet (aspirin) and anticoagulant (heparin) were administered. The patients were followed up for six months to several years after the operation. Results: Twelve patients were included in the study. The mean age (SD) was 49.2 (16.7%) years, with an age range of 22-78 years. The largest proportion (41.7%) of the sample were aged 40-49 years, and two thirds (66.7%) of the patients were female. The lip was affected in five patients out of eight (41.7%), and the tongue was affected in three patients (25%). Cancer was the cause of the defects in seven patients (58.3%), trauma in four patients (33.3%), and hemi-facial microsomia in one patient (8.3%). The success rate was 91.7%, with failure occurring in only one patient (8.3%). Conclusion: The radial artery free flap is versatile in the reconstruction of complex structures within the head and neck due to its high-quality fasciocutaneous properties, such as being thin, pliable, and having a long pedicle. This makes it particularly effective for lip and tongue reconstruction.
References
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