The nomenclature of venous flow‐through flaps: Updated classification and review of the literature

Abstract

Venous flow-through flaps (venous flaps) are useful reconstructive options, particularly in the repair of defects with segmental vessel loss. They are relatively easy to harvest and confer several benefits at the donor site. However, given that they are based on a single central vein, their survival is notoriously unreliable and they are susceptible to ischemia and venous congestion. Various designs have been suggested to improve the circulatory physiology, and hence survival, of venous flap. More recent designs involve adaptations to the arrangement and number of efferent veins draining arterialized venous flaps. The most commonly used classification system for venous flaps, proposed by Chen, Tang, and Noordhoff, does not afford adequate description of these alternate designs. This article offers a classification system that can incorporate all reported modifications to venous flaps. This simple adaptation to the classification system proposed by Chen et al. restores its usefulness in describing modern variations to venous flap design.

Arterialized Venous Flow-Through Flaps in the Reconstruction of Digital Defects: Case Series and Review of the Literature

“…Goldschlager et al modified the Chen classification of venous flow-through flaps [4]. Using the Goldschlager model, the flaps employed in our current series all use arterial inflow (arterialized) with either venous (type III) or arterial (type IV) outflow.…”

Syndactylizing arterialized venous flaps for multiple finger injuries

“…In previous studies, while successful venous flap reconstruction for the revascularization and reconstruction of single finger defects has been noted, there are limited publications available on syndactylizing venous flaps for soft tissue reconstruction of multiple finger defects . Recently, it has become possible to use venous flaps on larger, multi‐digit, asymmetric defects because of an increased understanding of venous flap perfusion dynamics and advances in preparation …”

“…Venous flaps have been an available option for reconstruction since their first use in 1981 . As a result of subsequent contributions, the survival rate of venous flaps has increased to over 90% …”

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

“…In addition, thin and pliable flaps can be obtained. Arterialized venous flaps can also be used, and survival is much more reliable . However, unlike the arterialized venous flap, the unipedicled venous flap does not require a microsurgical procedure or deep dissection, which simplifies surgery.…”