Arterialized Venous Bone Flaps: An Experimental Investigation

Abstract

In arterialized venous flaps (AVFs) the venous network is used to revascularize the flap. While the feasibility of AVFs in soft tissues has been reported there is no study on osseous AVFs. In this study we aim to assess the flap survival of osseous AVFs in a pig model. Medial femoral condyle flaps were elevated in 18 pigs. Three groups were created: AVF (n = 6), conventional arterial flap (cAF, n = 6) and bone graft (BG, n = 6). The AVFs were created by anastomosis of genicular artery with one vena comitans while leaving one efferent vein for drainage. After 6 months the specimens were harvested. The histology and histomorphometry of of the bone in cAF and AVF was significantly superior to bone grafts with a higher bone volume in AVFs (p = 0.01). This study demonstrates that osseous free flaps may be supported and survive using the technique of arterialization of the venous network. The concept of AVFs in osseous flaps may be feasible for revascularization of free flaps with an inadequate artery but well developed veins. Further experimental and clinical studies are needed to assess the feasibility of clinical use of arterialized venous bone flaps.

Unconventional Perfusion Flaps in the Experimental Setting: A Systematic Review and Meta-Analysis

“…[ See Table, Supplemental Digital Content 2 , which shows the summary of the studies on unconventional perfusion flaps in experimental animal models identified in the systematic review and included in the meta-analysis. 12,17,20,41,43,49-111 For each study, the optimized experimental animal model is identified, along with its characteristics. These experimental models were those that presented better flap survival rates in each published article ( p < 0.05).…”

“…Half of the identified articles were published until 1994, and three-quarters of these were published until 2003. Studies were performed in 20 different countries 12,17,20,41,43,49-111 (cited in Table, Supplemental Digital Content 2 , http://links.lww.com/PRS/D415). The most commonly used animal species was the rabbit (57.1 percent), followed by the rat (26.4 percent), the dog (14.3 percent), and the pig (2.2 percent).…”

Reconstruction of the temporomandibular joint using a vascularized medial femoral condyle osteocartilaginous flap: an experimental investigation in miniature pigs

“…To date, animal experimental studies on the MFC flap have been performed only in pigs. In 2016, Borumandi et al studied the long-term impact of arterialized venous bone flaps employed in pig MFC [ 19 ]. In 2018, Higgins et al compared the long-term cartilage quality of vascularized versus nonvascularized osteocartilaginous flaps of the MFC [ 20 ].…”

“…Among the large animals used for TMJ reconstruction research, pigs are the most suitable, since their joint, disc morphology and mandibular movement patterns are similar to those of humans [ 18 ]. Moreover, the vascularized MFC flap has only been studied in miniature pigs [ 19 , 20 ]. In the present study, we developed a miniature pig model of a unilateral vascularized MFC osteocartilaginous flap to regenerate an RCU defect.…”