This paper is only available as a PDF. To read, Please Download here.
It is accepted that small arterialised venous flaps (AVF) can survive on a recipient bed with poor blood supply but survival of larger flaps is not always satisfactory. Possible reasons for this include the flap anatomy, particularly the pattern of the venous network, or factors at the recipient site. To investigate the possible factors in the flap design and the recipient site of an arterialised venous flap, we studied the relationship between (1) size of the artery used to arterialise the flap at the recipient site and the survival rate and (2) the number of draining veins and the survival rate, using rabbit ear skin flap models. Our results suggest that AVFs may become necrotic in the presence of a relative excess of arterial blood inflow, and that two exit veins are more effective than one.
We also report a case where a 10 × 15 cm sized free AVF harvested from the lower extremity survived on the forearm.
- Heart failure as a complication of hemodialysis arteriovenous fistula.Annals of Internal Medicine. 1972; 77: 201
- Banding of arteriovenous dialysis fistulas to correct high-output cardiac failure.Surgery. 1975; 78: 552
- Cardiac failure and upper extremity arteriovenous dialysis fistulas. Case reports and a review of the literature.Archives of Internal Medicine. 1976; 136: 292
- Free transplantation of venous network pattern skin flap.Plastic and Reconstructive Surgery. 1988; 82: 892
- Diseases of the heart.3rd edn. W. B. Saunders Co., Philadelphia1966
- Experimental studies of skin flaps with subcutaneous veins.Journal of Reconstructive Microsurgery. 1989; 5: 249
- Experimental study of flow-through venous flap: investigation of the survival width and area with one flow-through vein preserved.Journal of Reconstructive Microsurgery. 1992; 18: 297
- Arterialized venous flap coverage for skin defects of the hand or foot.Journal of Reconstructive Microsurgery. 1984; 5: 151
- Resurfacing of skin defects of the hand using the arterialized venous flap.British Journal of Plastic Surgery. 1990; 43: 135
- Closure of big toe defects after wrap-around flap transfer using the arterialized venous flap.Journal of Reconstructive Microsurgery. 1991; 7: 1
- Free transplantation of venous network pattern flaps: an experimental study in rabbits.Microsurgery. 1984; 5: 151
- An arterialised venous flap using the long saphenous vein.British Journal of Plastic Surgery. 1991; 44: 23
- Digital venous anatomy.Journal of Hand Surgery. 1985; 10A: 473
- Creation of free flaps by arterialization of the venous system.Archives of Otolaryngology. 1984; 110: 221
- Flaps nourished by arterial inflow through the venous system: an experimental investigation.Plastic and Reconstructive Surgery. 1981; 67: 328
- Arterialized venous skin flaps for the injured finger.Journal of Reconstructive Microsurgery. 1989; 5: 357
- Cardiac failure following traumatic arteriovenous fistula: a report of fourteen cases.Journal of Trauma. 1965; 5: 398
- Prefabrication of skin flaps using vein grafts: an experimental study in rabbits.British Journal of Plastic Surgery. 1991; 44: 593
- An axial-pattern flap based on the arterialised venous network: an experimental study in rats.British Journal of Plastic Surgery. 1982; 35: 524
- The venous skin graft method for repairing skin defects of the fingers.Plastic and Reconstructive Surgery. 1987; 79: 243
Accepted: April 29, 1992
Received: February 24, 1992
© 1993 The British Association of Plastic Surgeons. Published by Elsevier Inc.