Arterialized Venous Flow-Through Flaps in the Reconstruction of Digital Defects: Case Series and Review of the Literature

Summary: Arterialized venous flow-through flaps are solely vascularized through the venous plexus. The flaps were first described 40 years ago; however, reports of venous congestion and ischemia discouraged surgeons from adopting them into their armamentarium. Nevertheless, recent studies have demonstrated a resurgence of venous flow-through flaps for reconstruction of small to medium defects of the hand and digits. Although current data report variable levels of success in adults, no case reports have been published in the pediatric population for this type of flap. In this study, an arterialized venous flow-through flap from the medial forearm was used to reconstruct a volar hand defect in a young child. Flap markings, surgical technique, and aftercare are described. The surgery was uncomplicated, and the postoperative outcomes were aesthetically and functionally excellent. Venous flow-through flaps restore full-thickness defects, are relatively easy to perform, allow an early return to daily activities, and have almost no morbidity. These flaps offer excellent options for pediatric hand and finger defects.

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“…Congestion can complicate postoperative recovery with a lengthened hospital stay and overall morbidity. 7 …”

Section: Discussionmentioning

confidence: 99%

The Pediatric Arterialized Venous Flow-through Flap

Efanov

ElHawary

Chollet

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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“…Although several authors have proposed algorithms based on their clinical experience and/or on the revision of clinical series, experimental data to systematically and unequivocally tackle these issues are strikingly lacking. 1,2,7,38,41–44…”

Section: Discussionmentioning

confidence: 99%

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

Casal

Tanganho

Cunha

et al. 2019

Plastic &Amp; Reconstructive Surgery

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“…In arterialized venous flaps the venous network is used to perfuse the harvested tissues. 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 technique 4 5 7 10 16 17 18 19 . AVFs may be harvested in a wide range of locations.…”

Section: Discussionmentioning

confidence: 99%

“…Variations have been reported in the arterial inflow technique (configuration of inflow vein(s), direction of inflow valves) as well as the means of providing outflow (efferent vein(s) or flowthrough artery) 2 3 . Experimental and clinical studies have demonstrated the feasibility and relative reliability of various AVF techniques 4 5 6 7 8 9 10 11 .…”

mentioning

confidence: 99%

Arterialized Venous Bone Flaps: An Experimental Investigation

Borumandi

Higgins

Buerger

et al. 2016

Sci Rep

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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.

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Arterialized Venous Flow-Through Flaps in the Reconstruction of Digital Defects: Case Series and Review of the Literature

Cited by 10 publications

References 12 publications

The Pediatric Arterialized Venous Flow-through Flap

The Pediatric Arterialized Venous Flow-through Flap

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

Arterialized Venous Bone Flaps: An Experimental Investigation

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