A Retrospective Analysis of 154 Arterialized Venous Flaps for Hand Reconstruction: An 11-Year Experience

Abstract

The authors conclude that the arterialized venous flap is a valuable and effective tool for reconstructing complex hand injuries and may have a more comprehensive set of indications.

Simultaneous coverage of two separate dorsal digital defects with a syndactylizing venous free flap

“…Both defects were successfully covered, and a very good functional outcome was reached. Though the concept of using a single venous flap to cover a multidigit defect with subsequent division is in the indexed literature, 16 postponing division until the 5th or 6th postoperative week is recommended. This paradigm may be applied to the longitudinal division of axial free flaps as well.…”

Salvage of the skin envelope in complex incomplete avulsion injury of thumb with venous arterializaiton: A case report

“…According to Woo et al, 7 the edema and discoloration was noted to last a couple of weeks. They thought that blood perfusion at a high arterial pressure cause dilatation of vein and stagnation of interstitial fluid in the tissue.…”

“…Salvaging the avulsed skin envelope using AV shunting is based on digit replantation 5,6,11 and using the arterialized venous flap. 7,10 The arterialized venous system can provide a high inflow blood pressure and nutrient supply via capillary network. Another circulation providing by AV shunt-ing seems to be practicable option, especially when several drainage veins are left in the remnant attached avulsed skin envelope.…”

The arterialized saphenous venous flow‐through flap with dual venous drainage

“…[15][16][17] The particular benefits of venous flaps comprise situations where arterial donor site morbidity is undesirable or in areas where large healthy veins could be found proximal and distal to the wound. 6 Common donor sites include distal volar forearm, saphenous and dorsalis pedis venous flaps, 3,4,8,15,[17][18][19][20] and even thenar and hypothenar areas. 17,21 With potentially easier dissection and a generally thin and nonbulky flap, 1 the greater quantity of available veins over arteries provides a substantially greater number of venous flaps available over arterial-based flaps.…”

“…Venous flaps were classified by Chen 6 and again by Thatte and Thatte, 7 with Woo et al ultimately subdividing the flaps into five types based on the presence and direction of the intravenous valves in the donor and recipient sites. 8 Although Thatte and Thatte classified their flaps into three types based on their direction and reference vessels, the more commonly used Chen classification categorized the venous flaps into four types based on their vascular ''hook-up.'' 6,9 The clinical applications of these flaps have similarly expanded.…”