{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T22:44:32Z","timestamp":1787870672323,"version":"build-2784847793"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,11,4]],"date-time":"2017-11-04T00:00:00Z","timestamp":1509753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000011","name":"Howard Hughes Medical Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000011","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007300","name":"China Medical University","doi-asserted-by":"publisher","award":["CMU 105\u2010 S\u201034"],"award-info":[{"award-number":["CMU 105\u2010 S\u201034"]}],"id":[{"id":"10.13039\/501100007300","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>In a vessel\u2010depleted neck, distant recipient sites may be the only option for secondary free flap reconstruction. While interposition vein grafts and arteriovenous loops can bridge the gap between the recipient and donor pedicle, they are not without risks. In these scenarios, we examinate the reliablity of a radial forearm free flap (RFFF) as an alternative vascular conduit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>A retrospective review of cases between March 2005 and May 2016 was performed. Demographic data, prior surgical history, intraoperative details and outcomes were recorded. A total of ten patients, eight male and two female, with a mean age of 54.2\u00a0years (range, 39\u201374) were identified. The RFFF was initially anastomosed to either the thoracoacromial (<jats:italic>n<\/jats:italic>\u00a0=\u00a06) or internal mammary vessels (<jats:italic>n<\/jats:italic>\u00a0=\u00a04) and subsequently served as the recipient pedicle for the second \u201cmain\u201d flap, an anterolateral thigh (<jats:italic>n<\/jats:italic>\u00a0=\u00a04), jejunum (<jats:italic>n<\/jats:italic>\u00a0=\u00a03) or fibula flap (<jats:italic>n<\/jats:italic>\u00a0=\u00a03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The average RFFF dimensions were 13.8\u00a0cm by 5.8\u00a0cm. All twenty flaps, ten RFFF and ten \"main' flaps survived completely with only one case of minimal epidermal loss. One patient with esophageal reconstruction with jejunum developed a fistula that required closure with a local falp. At a mean follow\u2010up of 18.4\u00a0months (range 8\u201329), the reconstructive goals had been achieved in all cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The RFFF serves as a reliable \u201cvascular bridge\u201d that extends the reach of distant recipient sites to free flaps in secondary head and neck reconstruction.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30259","type":"journal-article","created":{"date-parts":[[2017,11,4]],"date-time":"2017-11-04T11:56:39Z","timestamp":1509796599000},"page":"651-658","source":"Crossref","is-referenced-by-count":26,"title":["The radial forearm free flap as a \u201cvascular bridge\u201d for secondary microsurgical head and neck reconstruction in a vessel\u2010depleted neck"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4646-2676","authenticated-orcid":false,"given":"Pedro","family":"Ciudad","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery China Medical University Hospital Taichung Taiwan"},{"name":"Department of Biological Science and Technology China Medical University Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0242-0941","authenticated-orcid":false,"given":"Mouchammed","family":"Agko","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery China Medical University Hospital Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0337-8677","authenticated-orcid":false,"given":"Shivprasad","family":"Date","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery China Medical University Hospital Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei\u2010Ling","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery China Medical University Hospital Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar J.","family":"Manrique","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery China Medical University Hospital Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0462-7786","authenticated-orcid":false,"given":"Tony C. T.","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery China Medical University Hospital Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8901-3614","authenticated-orcid":false,"given":"Federico","family":"Lo Torto","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery China Medical University Hospital Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Trignano","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery China Medical University Hospital Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung\u2010Chi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery China Medical University Hospital Taichung 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