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The Indications and Reliability of Vein Graft Use in Free Flap Transfer

Background: Adequate recipient vessels are critical for free flap success. There are, however, situations in which the local recipient vessels are inadequate. In these situations, vein grafts are required to allow pedicle extension to recipient vessels. Objectives: To determine the indications, technique, reliability and outcome of vein graft use in free flap transfer. Methods: A retrospective review of 198 consecutive free flaps by a single surgeon. Results: Vein grafts were required in 9.6% of free flaps. The most common indication was vein graft use in a planned preoperative fashion. The vein graft was most commony placed as an arteriovenous fistula loop. There was no statistically significant difference in survival between flaps with or without vein grafts. Conclusion: Vein graft use in free flap transfer is reliable, effective and often necessary for free flap survival.