Arterialized venous free flap for reconstruction of burned face

Abstract

In this study, a forearm arterialized venous free flap (23 cm x 14 cm) was used in a 25-year-old male with facial burns sequels to reconstruct both cheeks, chin, lips, nose, columnella, nasal tip, and nostrils. It was arterialized by the facial artery to an afferent vein anastomosis. The venous flow was drained by four efferent vein to vein anastomoses. Although it developed small inferior marginal necrosis in the lower lip, the rest of the flap survived with good quality of the skin in both texture and color, with self-delimitation of the different esthetics units of the center of the face such as the nasogenian folds, nostrils, and upper lip filtrum, without the need of additional thinning surgical procedures. From all of the above, the arterialized venous free flap is an alternative reconstructive option for the treatment of burn sequels especially those that include the centrofacial region.

Nose resurfacing with free fasciocutaneous flaps in burns patients

“…Different types of free flaps have been used for nasal resurfacing, each one with its own advantages and disadvantages (Antunes & Chalian, ; Benmeir et al, ; Iglesias et al, ; Prousskaia et al, ). These flaps were usually fasciocutaneous flap, thin in both the skin and the soft tissue, creating the contour around the nasal framework and providing adequate lining without obstructing the nasal airway (Antunes & Chalian, ).…”

“…However, few reports demonstrating its application in burned nose are available. Most of them were only case reports or utilizing free flaps for reconstruction the face, but not focusing on nose (De Lorenzi et al, 2001;Iglesias, Butr on, Ch avez-Muñoz, Ramos-S anchez, & Barajas-Olivas, 2008;Prousskaia et al, 2015;Rose, 2015;Winslow, Cook, Burke, & Wax, 2003). Prousskaia et al pre-sented not only six free flaps in burned nose reconstruction but also included other reconstruction methods in their series (Prousskaia et al, 2015).…”

Arterialized Venous Bone Flaps: An Experimental Investigation

“…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.…”

“…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.…”

“…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.…”