Venous Flaps

Thatte, Mukund; Thatte, Ravin L.

doi:10.1097/00006534-199304000-00033

Cited by 51 publications

(18 citation statements)

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“…1,17 There are considerable controversies on the real nature of their survivals accompanied with their advent. Investigations on the blood supply of venous flaps mostly focus on type I and type II venous flaps.…”

Section: Mechanisms Of Flap Survivalmentioning

confidence: 99%

“…58,68 Whatever hypotheses of its survival mechanisms were put forward, the fundamental basis is that venous blood itself could be taken as the sole nourishing source at the early stage contributing to the support of its early survival in type I and type II venous flaps. 17,38,62 Apparently, venous blood has a lower pO 2 and accordingly is likely to be less nourishing in terms of energy metabolism of tissue. Therefore, the survival mechanism of type III venous flaps should not be compared with that of type I and type II venous flaps in terms of blood flow.…”

Section: Mechanisms Of Flap Survivalmentioning

confidence: 99%

“…Compared with conventional arterial flaps, venous flaps have advantages, including ease of design and harvest without the need to perform deep dissection, no sacrifice of a major artery at the donor site, no limitation of the donor sites, and less donor-site morbidity with optimal postoperative contour compared with other free microvascular tissue transfers. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Thatte and Thatte proposed a three-type classification system 17 of venous flaps. This classification, which was based on the vessels that enter and leave the flap as well as the direction of flow within these vessels, was detailed as follows: type I, unipedicled venous flaps; type II, bipedicled venous flaps; type III, arterialized venous flaps (AVFs), which are perfused by a proximal artery anastomosed with a cephalad end vein and drained by a distal vein.…”

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confidence: 99%

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Arterialized venous flaps: A review of the literature

et al. 2010

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The arterialized venous flaps are highly regarded in microsurgical and reconstructive surgeries based on advantages of ease of design and harvest without the need to perform deep dissection, no sacrifice of a major artery at the donor site, no limitation of the donor sites, and less donor-site morbidity. Many experimental investigations and clinical applications have been reported. However, their survivals are still inconsistent, and survival mechanisms remain controversial. In this review, we update the existing problems, experimental studies for survival mechanisms, clinical practices, and methods developed to improve their survivals.

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Section: Mechanisms Of Flap Survivalmentioning

confidence: 99%

Section: Mechanisms Of Flap Survivalmentioning

confidence: 99%

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confidence: 99%

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Arterialized venous flaps: A review of the literature

et al. 2010

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“…1,2 In the 19th century, local flaps were developed in the Western world by several surgeons, including Szymanowski, Burow, Esser, Lexer, Joseph, and Davis. 3 Forehead flaps were first performed in America in the 1830s by Warren.…”

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confidence: 99%

Forehead Flap Periorbital Reconstruction

Price

Sherris

Bartley

et al. 2004

Archives of Facial Plastic Surgery

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To evaluate functional and aesthetic results of periorbital defect repair using forehead flaps.Design: Retrospective review of patients who received periorbital defect repair by 3 of us with a paramedian forehead flap alone or in conjunction with other local or regional flaps, bone grafts, or cartilage grafts. Flap survival, functional results, and postoperative complications were determined by physical examination at regular followup. Three experienced surgeons other than us quantified aesthetic outcomes using a 10-cm visual analog scale.Results: Eighteen patients underwent periorbital defect repair between August 1, 1989, and December 31, 2000. Defects ranged from 8 to 300 cm 2 (mean, 46.8 cm 2 ) in area. The most commonly involved primary struc-tures were the medial canthus, lacrimal drainage system, and medial upper eyelid. The mean improvement on a 10-cm visual analog scale was 1.6 from before resection to after reconstruction and 3.8 from tumor resection to after reconstruction. In all relevant cases, globe coverage and lacrimal drainage system patency were excellent. No patients experienced fistula formation or eyelid retraction. Conclusion:The reliability, versatility, and relative technical simplicity of the forehead flap provide excellent cosmetic and functional results in reconstruction of intermediate-sized periorbital defects, especially those associated with nasal defects.

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“…[3][4][5] In venous flow-through flaps, not only a gradient of the venous pressure but also of the pO 2 between the afferent and efferent veins was determined 6 ; it is assumed that the gas exchange in these flaps occurs on the postcapillary level by bypassing the capillary network. [7][8][9][10] Capillaroscopically, a reflux from the veins into the capillaries could not be ascertained. 11 It is also controversial for arterialised venous flaps if high-pressure inflowing blood reaches the capillaries or not.…”

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confidence: 99%

Intracapillary haemoglobin oxygenation and interstitial pO2 in venous flaps: An experimental study in rats

Wolff¹,

Uekermann²,

Matthes³

et al. 1998

Microsurgery

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In order to be able to objectively evaluate capillary perfusion of venous flaps, we created arterialised venous flaps, venous flow-through flaps, and unilateral pedicled venous island flaps in the epigastric vascular system of Wistar rats and determined their oxygen supply with two different methods. Interstitial pO2 was polarographically measured with a probe placed intracutaneously in the center of the 4 x 2.5 cm flaps and continuously recorded on a connected computer. Moreover, we also noninvasively determined the oxygenation of the intracapillary haemoglobin with a micro-lightguide spectrophotometer. The statistical evaluation showed comparable results for both measurement methods: Arterialised venous flaps had a better oxygen supply with a pO2 of 16 mmHg and an Hb oxygenation of 23% than the other types of venous flaps, but they have a poorer oxygen supply than conventionally perfused flaps (pO2: 24 mmHg, Hb oxygenation: 30%). Venous flow-through flaps (pO2: 9 mmHg, Hb oxygenation: 17%) and unilateral pedicled venous island flaps had a significant better oxygen supply than skin flaps without any vascular connection. The results show that the capillary system in all types of venous flaps is reached by some of the inflowing oxygenated haemoglobin over the entire flap surface to different degrees.

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Venous Flaps

Cited by 51 publications

References 0 publications

Arterialized venous flaps: A review of the literature

Arterialized venous flaps: A review of the literature

Forehead Flap Periorbital Reconstruction

Intracapillary haemoglobin oxygenation and interstitial pO2 in venous flaps: An experimental study in rats

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