Clinical applications of venous flaps in the reconstruction of hands and fingers

Yan, Hede; Zhang, Feng; Akdemır, Ovunc; Songcharoen, Somjade J.; Jones, Nicholas I.; Angel, Michael; Brook, Darrell

doi:10.1007/s00402-010-1107-2

Cited by 44 publications

(54 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The main concern of AVFs is its survival status, which used to be considered as unreliable 18,30 ; however, with progressively technical modification, recent clinical practice has manifested that its survival rate can be comparable with that of the conventional flaps, especially when used for hand and finger reconstruction. 6,10 In this series, all the flaps survived completely. Undoubtedly, its postoperative process is not as favorable as that of the conventional flaps, such as venous congestion and bulla formation (Figs.…”

Section: Discussionmentioning

confidence: 57%

“…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. The main concern of AVFs is its survival status, which used to be considered as unreliable 18,30 ; however, with progressively technical modification, recent clinical practice has manifested that its survival rate can be comparable with that of the conventional flaps, especially when used for hand and finger reconstruction.…”

Section: Discussionmentioning

confidence: 58%

See 1 more Smart Citation

Reconstruction of Large Dorsal Digital Defects With Arterialized Venous Flaps

Yan¹,

Fan²,

Zhang³

et al. 2013

Annals of Plastic Surgery

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 58%

Reconstruction of Large Dorsal Digital Defects With Arterialized Venous Flaps

Yan¹,

Fan²,

Zhang³

et al. 2013

Annals of Plastic Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…Blood supply to unipedicled venous flaps remains controversial, and no clinical consensus has been reached regarding the mechanism of flap survival . Unipedicled venous flap perfusion hypotheses include plasmatic imbibition, pulse pressure in the preserved vein, and revascularization from the recipient bed with good blood circulation .…”

Section: Discussionmentioning

confidence: 99%

“…Skin and soft tissue injuries are treated using various types of flaps, particularly when deep structures such as bones or tendons are exposed. However, conventional flaps, including local, distant, island, and free flaps may be inappropriate in some cases due to the arc of rotation, flap bulkiness, sacrifice of an artery, long operative time, the need for microsurgery techniques, and others …”

mentioning

confidence: 99%

See 1 more Smart Citation

Influence of the pedicle orientation and length on viability of unipedicled venous island flaps

Han

Kim

et al. 2013

Microsurgery

View full text Add to dashboard Cite

The use of unipedicled venous flaps has been limited due to their unconventional perfusion patterns and inconsistent survival. Further information regarding the optimal conditions required for unipedicled venous flap coverage is needed to increase flap survival. The purpose of this study was to investigate the effect of the pedicle orientation and length on the viability of unipedicled venous flaps based on a review of our clinical experience. Thirty-one skin and soft tissue hand defects of 29 patients were treated with unipedicled venous flaps. Sixteen defects were treated with proximally pedicled flaps and 15 were treated with distally pedicled flaps. Five of the 16 proximally pedicled flaps and eight of the 15 distally pedicled flaps had pedicle lengths ≥ 5 cm. All proximally pedicled flaps survived, and distally pedicled flaps with pedicle lengths <5 cm (n = 7) also survived. Distally pedicled flaps with pedicle lengths ≥5 cm (n = 8) developed congestion within 1-2 days after surgery, and external bleeding was applied. Four of the eight flaps survived completely, and partial necrosis developed in the other four. The results demonstrate that proximally pedicled venous flaps of the hand can survive regardless of pedicle length. Distally pedicled venous flaps can also survive completely when pedicle length is <5 cm. Distally pedicled venous flaps with pedicle lengths ≥5 cm should be used with caution.

show abstract

A metabolic investigation of arterialized venous flaps in rabbits using mass spectrometry‐based metabolomics

Jin

Luo

Yuan

et al. 2021

Biomedical Chromatography

Self Cite

View full text Add to dashboard Cite

An arterialized venous flap (AVF) is an ideal choice of flap to repair wounds. However, the survival of these flaps remains the source of some concern. This study used metabolomic analysis to investigate the mechanisms underlying survival in AVF flaps in order to guide the clinical application of these flaps. Thirty-six male Japanese rabbits were randomly divided into a sham group and an AVF group. They were used for histology and hemodynamic investigations. Three days after surgery, tissue samples were analyzed by mass spectroscopy-based metabolomics. The results of the study revealed a reduction in blood flow, infiltration of inflammatory cells, and necrosis of flaps in the AVF group. In addition, notable changes were evident in the levels of several metabolites in the AVF group, including lactic acid, acetoacetic acid, inositol phosphate, arachidonic acid, and other metabolites. Our results indicate that the AVF group experienced changes in several biological pathways, including energy metabolism, cell membrane stability, and inflammatory response. There is a significant metabolic difference between AVFs and physiological flaps. The dysregulation in certain metabolites may be related to the specific hemodynamics and insufficient energy metabolism of the AVFs.

show abstract

Clinical applications of venous flaps in the reconstruction of hands and fingers

Cited by 44 publications

References 66 publications

Reconstruction of Large Dorsal Digital Defects With Arterialized Venous Flaps

Reconstruction of Large Dorsal Digital Defects With Arterialized Venous Flaps

Influence of the pedicle orientation and length on viability of unipedicled venous island flaps

A metabolic investigation of arterialized venous flaps in rabbits using mass spectrometry‐based metabolomics

Contact Info

Product

Resources

About