Venous Complications in One Versus Two Vein Anastomoses in Head and Neck Free Flaps.
OBJECTIVE
The purpose of this study was to compare rates of reexploration and flap failure in patients with 1- and 2-vein anastomoses in free flap reconstructions.


METHODS
Retrospective chart review of 300 patients undergoing free flap reconstruction to head and neck defects from 2010 to 2014.


RESULTS
One venous anastomosis was performed in 229 patients, and 2 venous anastomoses were performed in 71 patients. The 1-vein group had significantly more reexplorations in the operating room (36/229, 15.7%) compared with the 2-vein group (4/71, 5.6%; P = .028), even when controlling for flap type ( P = .022). This finding remained true among radial forearm flaps (17/81, 21% vs 3/53, 5.7%; P = .024). The number of venous anastomoses was not significantly associated with flap failure, though patients with flap failure did have a significantly greater proportion of venous issues ( P < .001).


CONCLUSIONS
Two-vein anastomoses do not appear to reduce rates of flap failure or postoperative venous thrombosis but are associated with a lower number of reexplorations in the operating room even after accounting for differences in flap types and surgeons.
['Khaja|Sobia F|SF|', 'Rubin|Nathan|N|', 'Bayon|Rodrigo|R|']
D000714:Anastomosis, Surgical D058752:Free Tissue Flaps D006085:Graft Survival D006258:Head and Neck Neoplasms D006801:Humans D011183:Postoperative Complications D012086:Reoperation D012189:Retrospective Studies D014680:Veins D020246:Venous Thrombosis D014947:Wounds and Injuries
free flap reconstruction free tissue transfer head and neck reconstruction microvascular reconstruction miscellaneous surgical outcomes