Wrap-Around Arterialized Venous Flap for Salvage of an Avulsed Finger

Koch, Horst; Moshammer, Harald; Spendel, Stephan; Pierer, Gerhard; Scharnagl, E.

doi:10.1055/s-2007-1000114

Cited by 16 publications

(5 citation statements)

References 6 publications

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“…2À24 This special kind of microvascular tissue transfer has the advantage of fast and easy flap harvest, resulting in short operating time compared to other free microvascular tissue transfers, versatility, 8,13,16,20,21 and low donor-site morbidity. The relatively small number of reported cases, however, tends to suggest limited clinical usefulness.…”

Section: Discussionmentioning

confidence: 99%

Clinical application of the retrograde arterialized venous flap

et al. 2004

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Retrograde arterialized venous flaps were applied to skin and soft-tissue defects in 13 patients with an average age of 34.4 years. Ten defects were located on the hand, and three on the lower leg. All flaps were harvested from the flexor aspect of the forearm; they ranged in size from 2 x 1 to 11 x 7 cm. There was venous congestion with superficial epidermolysis in six flaps, but not in the other seven. Partial skin necrosis in two of the lower-extremity flaps necessitated secondary skin grafts. Our results suggest that retrograde perfusion enhances blood flow in the periphery of arterialized venous flaps and gives good results in terms of flap survival, especially on the upper extremity.

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Section: Discussionmentioning

confidence: 99%

Clinical application of the retrograde arterialized venous flap

et al. 2004

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“…39 We used an AVF to reconstruct a ring avlusion injury with success, 47 and salvage of other degloved fingers with this flap was also reported. 13,33,36 Besides, it can serve as composite flaps not only for the coverage of skin defects but also for the reconstruction of tendon and nerve defects. However, many problems have also been encountered using this flap in clinical settings, especially in several relatively large series 4,15,23,30,48,49 except for Woo et al's report 16 (Table 1).…”

Section: Clinical Applications and Complicationsmentioning

confidence: 99%

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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“…[18][19][20][21][22][23][24][25][26][27][28][29][30][31] There have been far fewer papers written about the a-a venous flaps, and the flaps that have been described have been limited in size and used for reconstructing digital artery injuries associated with palmar soft-tissue defects. 19,24,26,29,[32][33][34] To date in the literature, it appears that the largest a-a venous flap to have survived was 6 Â 3 cm. 26 There are advantages in using venous flaps for reconstruction.…”

Section: Discussionmentioning

confidence: 99%

“…Third, the donor sites for venous flaps are in regions of the body where the skin is thin and pliable, making these flaps ideal for thin, well-vascularized, softtissue coverage. Although the most common donor site for venous flaps has been the palmar or dorsal forearm, 19,20,[22][23][24][25][26]28,[32][33][34] other sites have been used such as the dorsal foot, 18,26,30,32 medial ankle over the saphenous vein, 18,21,27 hypothenar/thenar regions, 29 dorsal hand, 19 and dorsal finger. 24 There is also great versatility in the venous flap, such that a composite flap can be designed to incorporate a tendon 20 or a nerve.…”

Section: Discussionmentioning

confidence: 99%

Arterialized Venous Flow-Through Flap for Simultaneous Reconstruction of a Radial Artery Defect and Palmar Forearm Soft-Tissue Loss from Sarcoma Resection

Deune¹,

Rodriguez²,

Hatef

et al. 2005

J reconstr Microsurg

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A 50-year-old right-handed male presented with a previously incompletely excised low-grade fibrous histiocytoma on his distal radial palmar forearm. Reoperative wide resection resulted in a segmental defect of the radial artery and a large soft-tissue defect with exposed tendons denuded of paratenon. An arterialized venous fasciocutaneous flow-through flap, measuring 8 x 3 cm, was harvested from the dorsal ipsilateral hand and used to reconstruct both the soft-tissue and the segmental radial-artery defects. A full-thickness skin graft was harvested from the ipsilateral groin to cover the dorsal hand wound. Moderate venous congestion was noted in the flap on postoperative day 1 and treated with four days of leeches. Approximately 10 percent of the flap was lost due to the venous congestion. The flap healed well without further complications. At 33 months the flap remained well-perfused, with excellent flow through the reconstructed radial artery evidenced by both clinical examination and by color vascular Doppler exam. The patient had full range of motion in his right hand despite initial postoperative stiffness and reported no cold intolerance in the right hand. There has been no local recurrence of the sarcoma. The authors believe that this is the largest arterialized venous flow-through flap currently reported to have survived, as well as the first reported case of its use for the simultaneous reconstruction of a radial artery defect and an associated soft-tissue loss.

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Wrap-Around Arterialized Venous Flap for Salvage of an Avulsed Finger

Abstract: The case of an avulsed finger with extensive soft-tissue trauma is presented. The digit was salvaged using an arterialized wrap-around flow-through venous flap from the forearm.

Cited by 16 publications

References 6 publications

Clinical application of the retrograde arterialized venous flap

Clinical application of the retrograde arterialized venous flap

Arterialized venous flaps: A review of the literature

Arterialized Venous Flow-Through Flap for Simultaneous Reconstruction of a Radial Artery Defect and Palmar Forearm Soft-Tissue Loss from Sarcoma Resection

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