Surgical technique ottie van zyl the radial free forearm flap rfff was one of the first free tissue transfer flaps to. The skin incision should begin distally and proceed subfascially taking care to preserve paratenon. It refers to a vein that is usually paired, with both. In some critical cases, use of the deep venous circle may represent an alternative approach and venae comitantes could be employed for this purpose. Anastomosis of the venae comitantes at the level of the perforating vein is also more technically challenging compared to the level of the main pedicle diev. The deep system provides most part of the venous outflow if the caliber of the venae comitantes vcs is adequate.
Damage to the radial nerve occurred in 9% 111 of patients in the cephalic vein group versus 18% 428 in the venae comitante group. Microvascular surgery protocols general considerations. The importance of the intact venae comitantes in the drainage of free radial forearm flaps has been well documented. Micro vascular free flaps used in head and neck reconstruction certified fixed orthodontic courses by indian dental academy. The venae comitantes clipping test for the evaluation of. Looking for online definition of venae comitantes in the medical dictionary.
Scheme of the distallybased anterolateral thigh free flap with a modified vena comitans. We feel that dissection and handling of the perforator and its venae comitantes should be minimal in order to prevent damage and total loss of an already compromised flap. The venae comitantes clipping test for the evaluation of the venous drainage of the radial forearm free flap article pdf available in microsurgery 368 october 2015 with 116 reads. The main trunk of the nonvenae comitantes was the superficial inferior epigastric vein, and it formed.
Conclusion recently, venous outflow problem rather than. Home october 1998 volume 102 issue 5 reliability of the venae comitantes in venous drainage of th. Information and translations of vena comitans in the most comprehensive dictionary definitions resource on the web. Free flap phalloplasty for female to male gender dysphoria giulio garaffa, md, phd, fecsm, frcs eng, david j. Distallybased free anterolateral thigh flap with a modified vena. Registered users can save articles, searches, and manage email alerts. It refers to a vein that is usually paired, with both veins lying on the sides of an artery. Free flap phalloplasty for female to male gender dysphoria. For the vascular graft, the descending branch of the lateral circumflex femoral artery and two venae comitantes were harvested. To evaluate the reliability of the deep venous system, a. Retrospective study comparing subjective and objective symptoms of radial nerve morbidity in 51 consecutive free flaps over a 3. Analysis of the anatomy of the venae comitantes related to the. Venous circulation an overview sciencedirect topics. Intraoperatively, there was a severe injury to the right superficial temporal vessel because of previous neurosurgical operations.
Raising the cephalic vein for venous drainage in the radial artery free flap doubles the incidence of radial nerve morbidity. Venae comitantes definition of venae comitantes by. Anatomical relationship between arteries and veins in the. As such, they run parallel to their opposing arteries. Because they are generally found in pairs, they are often referred to by their plural form. Care is taken to not damage the superficial sensory branch of the radial nerve during the dissection. Scalp free flap reconstruction using anterolateral thigh. In this small series of patients the venae comitantes clipping test showed to be an easy. Dividing and ligating the distal artery early makes the flap easier to harvest.
Looking for online definition of vena comitans in the medical dictionary. Looking for online definition of venae or what venae stands for. Volume 21, issue 5, septemberoctober 2007, pages 560563. The venae comitantes of the brachial artery offer an additional source of autogenous vein. The deep veins are venae comitantes of the main arteries.
Request pdf radial nerve morbidity in radial artery free flaps. Radial forearm free flap atlas of operative oral and. Tell a friend about us, add a link to this page, or visit the webmasters page for free fun content. Harvest of cephalic vein versus venae comitantes the purpose of the present paper was to determine the radial nerve morbidity. Risks of failure of the radial forearm free flap frff are mainly related to venous congestion. Indications the forearm flap has been used for just about everything imaginable in the area of head and neck reconstruction. Revisiting radial forearm free flap for successful venous.
Reliability of the venae comitantes in venous drainage of. Vena comitans definition of vena comitans by the free. They are generally arranged in pairs, and are situated one on either side of the corresponding artery, and connected at intervals by short transverse branches. Vena comitans definition of vena comitans by medical dictionary. Pdf risks of failure of the radial forearm free flap frff are mainly related to venous congestion.
Radial forearm free flap iowa head and neck protocols. A small section of the radial artery and its two venae comitantes is exposed. Modified reverseflow alt free flap, wherein the venae comitantes are anastomosed to the proximal vein stump, is a good option that allows for relatively simple pedicle extension within the same operative field when securing an adequate pedicle length is difficult because of the origin of the perforator from the proximal descending branch. The procedure was done in two stages, first anastomosis between brachial artery at the elbow and one of its venae comitantes and, 1 month later, transposition of the vein to a. Vena comitans definition of vena comitans by medical. Radial nerve morbidity in radial artery free flaps. Vena comitans medical definition merriamwebster medical. T1 gracilis muscle free flap transfer using a radial arteryvenae comitantes composite vascular pedicle. The authors also found the vein of the finger, that had bicuspid valves, but not in venae comitantes. Vascular anatomy of the upper limb student council. These examples are from the cambridge english corpus and from sources on the web. The venae comitantes clipping test for the evaluation of the venous drainage of the radial forearm free flap.
To evaluate the reliability of the deep venous system, a single radial vena comit. The rectus abdominis free flap is raised as a muscleonly, myocutaneous or perforator. Revisiting radial forearm free flap for successful venous drainage. The radial venae comitantes are usually considered as an accessory venous outflow tract in the free radial forearm flap because of their smaller size and thinner structure when compared with those of the cephalic vein.
The arteriovenous fistula avf represents the gold standard for hemodialysis hd vascular access. Revisiting radial forearm free flap for successful venous drainage yong hoon cha, woong nam, inho cha and hyung jun kim abstract tissue defect reconstruction using radial forearm free flap rfff is a common surgical technique whose success or failure is mainly dependent on venous drainage. Veins of the upper extremities are grouped into deep veins which are accompanying veins of arteries from which they derive their names latin. Venae comitantes as a potential vascular resource to. Distallybased free anterolateral thigh flap with a. An allens test is performed to verify collateral circulation from the ulnar artery.
Modified reverseflow alt free flap, wherein the venae comitantes are anastomosed to the proximal vein stump, is a good option that allows for. This makes for a more efficient circulatory system. Larger arteries are typically accompanied by only a single. Use of a harvested radial artery graft with preservation. The deep system provides most part of the venous outflow if the caliber of the venae comitantes vcs is. Register for a free account existing user log in existing user log in. Pdf the venae comitantes clipping test for the evaluation of the. Pairs of veins that often accompany small arteries. Two different venous drainage system have been described for the frff, but the choice of the best one is still controversial. Deep venae comitantes drain into the median cubital vein, communicating with superficial veins at the elbow area. Two venous systems can serve as recipient vessels in free flap surgery. They are found in close proximity to arteries so that the pulsations of the artery aid venous return.
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