Abstract
In arterialized venous flaps (AVFs) the venous network is used to revascularize the flap. While the feasibility of AVFs in soft tissues has been reported there is no study on osseous AVFs. In this study we aim to assess the flap survival of osseous AVFs in a pig model. Medial femoral condyle flaps were elevated in 18 pigs. Three groups were created: AVF (n = 6), conventional arterial flap (cAF, n = 6) and bone graft (BG, n = 6). The AVFs were created by anastomosis of genicular artery with one vena comitans while leaving one efferent vein for drainage. After 6 months the specimens were harvested. The histology and histomorphometry of of the bone in cAF and AVF was significantly superior to bone grafts with a higher bone volume in AVFs (p = 0.01). This study demonstrates that osseous free flaps may be supported and survive using the technique of arterialization of the venous network. The concept of AVFs in osseous flaps may be feasible for revascularization of free flaps with an inadequate artery but well developed veins. Further experimental and clinical studies are needed to assess the feasibility of clinical use of arterialized venous bone flaps.
Highlights
Arterialized venous flaps (AVFs) are tissue flaps harvested without conventional vascular pedicles
No significant difference in bone volume or trabecular thickness was found between the two vascularized groups conventional arterial flap (cAF) and arterialized venous flaps (AVFs) (Table 1)
The advantages gained by this technique in transfer of skin flaps brings into question whether other tissues could be perfused via arterialization of the venous system
Summary
Arterialized venous flaps (AVFs) are tissue flaps harvested without conventional vascular pedicles. Experimental and clinical studies have demonstrated the feasibility and relative reliability of various AVF techniques[4,5,6,7,8,9,10,11]. The mechanism of successful tissue perfusion of AVFs is unclear, clinical and experimental experience has confirmed skin flap survival using this unconventional technique. This has widened the scope of possible donor sites for skin flap harvest and minimized donor site morbidity. It is unknown whether the potential advantages of this technique could be employed in flaps containing other tissue types. The goal of this study is to assess the feasibility of AVFs for the osseous flap perfusion via arterialization of the venous system
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