Arterialized venous flaps: A review of the literature

Yan, Hede; Brooks, Darrell; Ladner, B S Raven; Jackson, William D.; Gao, Weiyang; Angel, Michael

doi:10.1002/micr.20769

Cited by 54 publications

(47 citation statements)

References 84 publications

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“…In a recent systematic review (Yan et al, 2010b), congestion rates of up to 100% in certain series and a partial necrosis rate and total necrosis rate of 42.5% and 7.5%, respectively, were reported. While it is accepted that a 100% flap success rate cannot be universally achieved for any types of flap, the problem seemed to be worse in venous flaps, as often the reason for flap failure remains unclear, making it difficult or even impossible to reliably prevent future flap failures.…”

Section: Introductionmentioning

confidence: 97%

The physiology, microcirculation and clinical application of the shunt-restricted arterialized venous flaps for the reconstruction of digital defects

Lam

Lin

Bell

et al. 2012

J Hand Surg Eur Vol

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Reconstruction of digital defects using the venous flap offer several advantages but remained unpopular owing to levels of venous congestion rates. We performed animal studies to test the hypothesis that an arterio-venous shunt increases pressure for peripheral flap perfusion and decreases venous congestion. Using an abdominal adipofascial flap model in six male Sprague-Dawley rats, microcirculation was modified as follows: type I - arterial flap; type II - flow-through arterio-venous flap (AVF); and type III - shunt-restricted AVF. In type I flaps, blood flow was observed to be unidirectional in both arterioles and venules. In type I flaps, blood flow was observed to be unidirectional in both arterioles and venules. In type II flaps, blood flow oscillated without a dominant direction and came to a standstill. In type III flaps, blood flowed proximally in a reverse direction whereas distally, flow was similar to type I flaps. In a clinical series, 21 patients received a total of 22 shunt-restricted AVFs. All 22 clinical flaps survived; four flaps suffered epidermolysis but recovered without full thickness loss.

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Section: Introductionmentioning

confidence: 97%

The physiology, microcirculation and clinical application of the shunt-restricted arterialized venous flaps for the reconstruction of digital defects

Lam

Lin

Bell

et al. 2012

J Hand Surg Eur Vol

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“…Since this early experience, we have employed the technique of two sources of outflow, and our ultimate results have improved concordantly, in fact comparing favorably with any other described technique for venous outflow in these arterialized flaps, even where good results have been described. 25,[51][52][53] Unlike Lin et al, we were able to cover defects using substantially larger flap sizes of up to 8 3 20 cm 2 . We attribute this to: (a) using arterialized venous flaps only; (b) reversing the flap such that the venous valves were orientated in the direction of blood flow to allow unimpeded flow during arterialization; and (c) anastomosing an additional vein that is not connected to the central vein to enable dual venous drainage through two systems.…”

Section: Casementioning

confidence: 46%

“…Although a true understanding of the physiology of the venous flow through flap is still not completely clear, we have found that augmentation of both the arterial inflow and venous drainage can aid flap survival and offer a unique approach to achieving this. 53 …”

Section: Casementioning

confidence: 97%

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

et al. 2012

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“…skin flap but also as a composite flap including tendons and nerves as well as vein grafts. 29 All these advantages make it an optimal candidate for hand and digit reconstruction when conventional flaps are limited or unavailable. 6 In our series, satisfactory results were achieved for flap survival, functional recovery, aesthetic outcomes as well as the number of secondary revision required.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of Large Dorsal Digital Defects With Arterialized Venous Flaps

Yan¹,

Fan²,

Zhang³

et al. 2013

Annals of Plastic Surgery

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Coverage of the dorsal aspect of the fingers is difficult, especially when the defect is large and multiple digits are involved with composite tissue loss and very few conventional flaps are suitable in dealing with such situation. The purpose of this study was to present our experience of reconstruction of the large dorsal digital defects with the arterialized venous flap (AVF) and evaluate its merits and demerits in this clinical setting with a comprehensive review of literature. From August 2008 to December 2010, 7 composite palmaris longus venous flaps and 5 AVFs were used in the reconstruction of extensive dorsal digital injuries in 8 patients, and a comprehensive review of literature regarding the reconstruction of dorsal digital defects with AVFs was carried out. All the flaps survived completely. The outcomes were very satisfactory for functional recovery, aesthetic appearance, and sensation restoration at an average follow-up of 11.8 months; the literature review also revealed the similar results. On the basis of our experience and literature review, AVFs are reliable and good candidates for resurfacing large dorsal digital defects when local flaps are not available or insufficient for coverage. Composite AVF with palmaris longus tendon is an optimal choice for 1-stage reconstruction of dorsal composite finger injuries.

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Arterialized venous flaps: A review of the literature

Cited by 54 publications

References 84 publications

The physiology, microcirculation and clinical application of the shunt-restricted arterialized venous flaps for the reconstruction of digital defects

The physiology, microcirculation and clinical application of the shunt-restricted arterialized venous flaps for the reconstruction of digital defects

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

Reconstruction of Large Dorsal Digital Defects With Arterialized Venous Flaps

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