Versatility of the radial forearm free flap in head and neck reconstruction. A study of 58 cases

Radial forearm free flap and a freka-trelumina tube for management of a refractory pharyngocutaneous fistula: A case report

The management of pharyngocutaneous fistulas (PCFs) is challenging. A multidisciplinary treatment approach according to the clinical needs of a patient is essential for PCF management. Here, we describe the use of a double-layer closure technique involving a radial forearm free flap (RFFF) and a Freka-Trelumina nasojejunal tube in the reconstruction of a refractory PCF.

Pedicled Supraclavicular Artery Island Flap Versus Free Radial Forearm Flap: Perioperative Outcomes in Head and Neck Reconstruction

INTRODUCTION

Radial forearm free flap (RFFF) and supraclavicular artery island flap (SCAIF) are some of the most common fasciocutaneous flaps used for head and neck (H&N) reconstruction.

MATERIAL AND METHODS

A retrospective analysis of clinical data and outcomes of 31 consecutive patients who underwent H&N reconstruction using either SCAIF or RFFF over a three-year period, aiming to compare the surgical outcomes of the SCAIF and the RFFF in H&N reconstruction.

RESULTS

Thirty-two flaps were performed in 31 patients (17 SCAIFs and 15 RFFFs). There was no difference in patient demographics between both groups. Hospital stay was longer in the SCAIF group (30.7 ± 18.2 days (min: 9/max: 60) versus 19.2 ± 15.8 days (min: 7/max: 72). Patients who underwent reconstruction with a SCAIF had shorter reconstructive procedure time; 74.4 min (min: 60/max: 93) versus 147.8 min (min: 140/max: 187). Overall morbidity was not significantly different (SCAIF 52.7% vs RFFF 39.9%, p = NS). Global flap survival was higher without statistical significance in the RFFF group (100%) versus the SCAIF group (70.7%).

CONCLUSION

Despite the advantages related to the use of SCAIF like regarding the time spent in the reconstructive procedure. In our experience, the RFFF continues to be the most successful technique with similar perioperative outcomes and fewer complication rates. In this vein, both techniques can be reasonably used to reconstruct post-ablative H&N defects. However, in our experience, the use of SCAIF may lengthen hospital length of stay probably due to the augmented risk of flap failure.