A novel rabbit model for the evaluation of retrograde flow venous flaps

Abstract

Venous flaps have several potential advantages over traditional flaps, but their uses have been limited by unpredictable survival. Although clinical and experimental studies have concentrated mainly on the antegrade arterialization of venous flaps to increase survival, retrogradely arterialized venous flaps (AVFs) may have the greatest potential. There is, however, little literature on their use. There are also no animal studies comparing their survival to other venous flaps used in a similar situation. Our aim was to design a flap utilizing the rabbit's valved, thoracoepigastric vein (consisting of the lateral thoracic and epigastric veins) as the source vessel for the study of retrograde arterialized venous flaps (RAVFs). A pilot study (n = 10) to determine the survival of RAVFs was performed utilizing this animal model. Four flaps had complete survival at the end of our 2-week observational period. However, we also had four partial flap losses and two cases in which the entire flap was lost. An average survival area of 44.5% was observed. In conclusion, our designed rabbit thoracoepigastric RAVF is simple to apply and easily reproducible. It is the first animal flap adapted specifically for the study of RAVFs, and may be used for the further investigation of these flaps, which have shown unpredictable survival to date.

Arterialized Venous Bone Flaps: An Experimental Investigation

“…Although the exact mechanism of successful tissue perfusion in AVFs is unclear, various clinical and experimental studies have confirmed skin flap survival using this unconventional technique4571016171819. AVFs may be harvested in a wide range of locations.…”

The nomenclature of venous flow‐through flaps: Updated classification and review of the literature

“…However, this technique remains unreliable, complicated by full‐thickness necrosis, postoperative bulkiness, and venous congestion 2. 51…”

Revascularization of Arterialized Venous Flaps through a Total Retrograde Reverse Blood Flow

“…Several experimental studies and clinical applications have been performed to evaluate whether different surgical procedures could enhance flap perfusion and flap survival. 2,4–15 These experimental procedures include increasing angiogenesis by flap preexpansion, 4,7,8 prearterialization technique, 4,9,10 and surgical and pharmacological flap delay procedures. 2,4,11,16–20 These procedures have been used successfully to increase flap blood flow and tissue oxygenation.…”

“…2–4,13,25,27,29–33 Composite flaps have been used for reconstruction of nerves, vessels, and tendons, 13,21,34–37 while AVFs have also been used in reconstruction of small hand defects. Small-sized AVFs (1 × 1 cm up to 3 × 10 cm) have a 95–100% survival rate.…”

“…The chosen experimental model was the rabbit ear because it contains a well-defined vascular pedicle and a valved venous system. 2,10,16,17,39,40 …”