Revascularization of Arterialized Venous Flaps through a Total Retrograde Reverse Blood Flow

Iglesias, Martin; Fonseca-Lazcano, José A.; Moran, M.; Butrón, Patricia; Díaz-Morales, Melina

doi:10.1097/gox.0b013e3182a4bc9d

Cited by 5 publications

(4 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…AVFs have been used in a wide variety of reconstructions for hand, upper limb, lower limb, foot, face, oral cavity, and neck (Pittet et al, 2008). The advantages have been widely reported (Koch et al, 2004; Rozen et al, 2012; Yan et al, 2010), despite higher rates of flap loss, both total and partial (Iglesias et al, 2013; Rozen et al, 2012; Zheng et al, 2016). The use of our technique described aims to optimize the physiological perfusion and survival mechanisms of AVFs: “AV shunting” or retrograde flow from the venous system to the arterial system via paralyzed AC shunts, “reverse flow” or flow from the venules into the capillaries, and “capillary bypass” or flow through the venous system without entrance into the arterial side until neo‐vascularisation (Iglesias et al, 2013; Rozen et al, 2012; Yan et al, 2010; Zheng et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

The arterialised saphenous venous flow‐through flap for managing the radial forearm free flap donor site

et al. 2022

View full text Add to dashboard Cite

Background The radial forearm fasciocutaneous flap (RFFF) is a workhorse flap, however concerns with donor site morbidity include tendon exposure, delayed wound healing, impaired sensitivity, and poor cosmesis, have seen it fall out of favor. We present a method of using an arterialised saphenous flow through flap to reconstruct the RFFF donor site. Method A cohort study of six patients (five male, one female; mean age 59 [range 19–90]) who had their RFFF donor site reconstructed with an arterialised saphenous flow through flap is presented. The use of multiple peripheral efferent venous anastomoses, flap rotation 180 degrees prior to inset, and the ligation of intra‐flap connecting veins were three modifications employed. Primary outcomes include complication rates. Secondary outcomes were patient reported outcome measures via the Michigan Hand Outcomes Questionnaire, and patency and flow through the flap. Results In all six cases, there was flap survival. RFFF dimensions ranging from lengths of 6–15 cm (mean 11.5 cm) and widths of 4–6 cm (mean 5.3 cm), with an average flap area of 58 cm2 (range 24–90). There were no total flap losses, one partial superficial flap loss and one minor donor site delayed healing, over a mean follow‐up of 6 months (4–24 months). The average overall patient satisfaction was 91 on Michigan Hand Outcomes Questionnaire. Pain was well tolerated with a low average pain score of 15. Conclusion The modified arterialised saphenous flow through flap is a useful option for reconstructing the soft tissue defect and reconstituting the radial artery after RFFF harvest.

show abstract

Section: Discussionmentioning

confidence: 99%

The arterialised saphenous venous flow‐through flap for managing the radial forearm free flap donor site

et al. 2022

View full text Add to dashboard Cite

show abstract

“…2 It has been well proven by various studies that retrograde flow plays a role in survival of venous flaps. 9 The presence of flap survival along the proximal part of flap may be due to retrograde flow from lateral thoracic vein.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Role of Arterialization of Venous Flaps in Abdomen in Rats

Aggarwal

Singh

Halageri

et al. 2021

Indian J Plast Surg

View full text Add to dashboard Cite

Introduction Reconstruction forms the primary tenet in plastic surgery. Venous flaps are a known option but the survival is limited. Arterialization of venous flap can enhance its survival. While various techniques of arterialization of venous flaps are described, there are very few studies comparing them. Material and methods The current study was conducted among 34 rats weighing 160 to 200 grams. The rats were divided into four groups. Group I—islanded epigastric flap was raised with superficial caudal epigastric vessels as pedicle. Group II—arterialized flow through venous flap was raised with superficial caudal epigastric vein (SCEV) as afferent and lateral thoracic vein as drainage vein. Side-to-side anastomosis was done between femoral artery and vein, lateral to the origin of superficial caudal epigastric artery. Group III—after raising the flap, as in group II, femoral vein was ligated proximal to superficial caudal epigastric vessels. Group IV—an arterialized flow through venous flap was raised with superficial caudal epigastric vein as afferent and lateral thoracic vein as drainage vein. End-to-side anastomosis was done between femoral artery and superficial caudal epigastric vein. Animals that died before completion of the study were excluded. The color changes of flaps were noted. Flap survival was expressed as a percentage of the total flap surface area. The patency of anastomosis was seen on postoperative day 5. Results There was no total flap failure. On statical analysis, the flap survival area on day 5 between Group I and Group IV was not significant (p value 0.431). The survival area in Group I (78.85 ± 10.54%) was comparable to Group IV (65.71 ± 20.70%). Group II and III had poor results as compared with Group I. In four rats, thrombosis of arteriovenous anastomosis was noted with flap survival area of 30 to 33%. Conclusion It was noted that epigastric venous flaps with end-to-side anastomosis between femoral artery and superficial caudal epigastric vein (group IV) have survival area comparable to islanded flaps.

show abstract

“…At 4 months postoperatively, although mild atrophy that was one of common complications with arterialized venous flap was noted, 8 the morphology of the finger was favorable ( Figure 4A ). Satisfactory synostosis was also observed radiographically.…”

Section: Case Presentationsmentioning

confidence: 99%

A New Procedure for Wrapped-Negative Pressure Wound Therapy for Congestion After Arterialized Venous Flap Surgery

Niimi

Mori

Takeuchi

2017

Clin Med Insights Case Rep

View full text Add to dashboard Cite

Negative pressure wound therapy (NPWT) is a method for treating wound. However, there are no case reports using NPWT for treating congestion after arterialized venous flap. Therefore, this study reported favorable outcomes after using a single-use NPWT system for managing congestion. A 39-year-old man had his index finger caught by a press machine. The finger had a soft tissue defect at the ventral part. An arterialized venous flap taken from the right forearm was transplanted. Perfusion of the flap was favorable, but on postoperative day 5, congestion and the edema of the flap were found. Then, NPWT was initiated. The congestion and edema in the flap were improved without complications such as flap necrosis and wound infection. At 4 months postoperatively, the morphology of the finger was favorable. In this study, NPWT was speculated to force the deeper blood vessels within the flap to dilate with inducing drainage and the simultaneous reduction in excess blood flow to the cortical layer, resulting in the improvement of congestion. Negative pressure wound therapy was used for treating congestion after the transplantation of arterialized venous flap, and the wound was favorably managed.

show abstract

Revascularization of Arterialized Venous Flaps through a Total Retrograde Reverse Blood Flow

Cited by 5 publications

References 48 publications

The arterialised saphenous venous flow‐through flap for managing the radial forearm free flap donor site

The arterialised saphenous venous flow‐through flap for managing the radial forearm free flap donor site

Evaluation of Role of Arterialization of Venous Flaps in Abdomen in Rats

A New Procedure for Wrapped-Negative Pressure Wound Therapy for Congestion After Arterialized Venous Flap Surgery

Contact Info

Product

Resources

About