Clinical applications of free arterialized venous flaps

Kayalar, Murat; Küçük, Levent; Sügün, Tahir Sadık; Gürbüz, Yusuf; Savran, Ahmet; Kaplan, İbrahim

doi:10.1016/j.bjps.2014.05.061

Cited by 20 publications

(19 citation statements)

References 44 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…AVFs may be harvested in a wide range of locations. The harvest is technically less demanding and more superficial than conventional arterial pedicle flaps, permitting rapid harvest of very thin tissue57810. The advantages gained by this technique in transfer of skin flaps brings into question whether other tissues could be perfused via arterialization of the venous system.…”

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)23. Experimental and clinical studies have demonstrated the feasibility and relative reliability of various AVF techniques4567891011.…”

mentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Arterialized Venous Bone Flaps: An Experimental Investigation

Borumandi

Higgins

Buerger

et al. 2016

Sci Rep

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“…However, enthusiasm has been dampened by their high rates of venous congestion (53.6%), increased need for reoperation (7%), and high rates of flap failure (9.7%). 30 Comparison of arterialized venous flaps with radial artery perforator flaps, PIA perforator flaps, and ulnar artery perforator free flaps demonstrated that venous free flaps had significantly shorter operative times, improved cosmetic outcomes, and optimal sensory recovery. 31 …”

Section: Venous Free Flapsmentioning

confidence: 98%

Management of Soft Tissue Defects of the Hand

Yannascoli

Thibaudeau

Levin

2015

The Journal of Hand Surgery

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“…This avoids syndactylizing the fingers which has been described with other methods of free tissue transfer for hand trauma. 15…”

Section: Surgical Techniquementioning

confidence: 99%

The Versatility of the Superficial Circumflex Iliac Artery Perforator Flap: A Single Surgeon's 16-Year Experience for Limb Reconstruction and a Systematic Review

Berner

Nikkhah

Zhao

et al. 2019

J reconstr Microsurg

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Background The superficial circumflex iliac artery perforator (SCIP) flap is a versatile option of free tissue transfer for small to large defects. In this study, we examine the advantages of the SCIP flap, its cadaveric anatomy, and clinical subtypes. Methods Ten cadavers were dissected and the corresponding pedicles of the SCIP and groin flaps were identified. A retrospective review of 20 clinical cases of free SCIP flap reconstruction was undertaken. The indication for reconstruction, flap dimensions, and survival were analyzed. A systematic literature review was conducted including articles that have previously reported the use of the SCIP flap. Results The SCIP pedicle was present in all our cadaveric dissections. The starting point of its pedicle ranged from 1.5 to 4.5 cm along the superficial circumflex iliac artery. The median diameter of the perforator and its concomitant vein was 1mm (range 0.8–2 mm). A cutaneous vein (1.3–2.3 mm) could be included in the flap if the concomitant vein was too small. Twenty consecutive patients had free SCIP flaps between 2002 and 2018. The indications were for finger defects (n = 8), thumb reconstruction (n = 1), lower limb compound fractures (n = 3), iatrogenic wounds (n = 2), upper limb large defects (n = 2), and scar contractures (n = 4). Flap dimensions ranged from 2 × 4 cm to 14 × 25cm, and the longest pedicle was 8cm. All flaps survived. The systematic literature review identified 34 previous reports using the SCIP flaps, most of these published by Asian units. Conclusion The SCIP flap is useful for reconstruction throughout the body due to its ease of dissection, thinness, adjustable pedicle length, and flap dimension ranging from tiny to large, as well as the feasibility of raising a compound flap incorporating an adipofascial or vascularized bone component if necessary.This is a level of evidence therapeutic IV study.

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Clinical applications of free arterialized venous flaps

Cited by 20 publications

References 44 publications

Arterialized Venous Bone Flaps: An Experimental Investigation

Arterialized Venous Bone Flaps: An Experimental Investigation

Management of Soft Tissue Defects of the Hand

The Versatility of the Superficial Circumflex Iliac Artery Perforator Flap: A Single Surgeon's 16-Year Experience for Limb Reconstruction and a Systematic Review

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