Free Arterialized Venous Flaps

Abstract

The reconstruction of the soft tissue defects with the free arterialized venous flaps is an alternative method to the conventional flaps. In this article, we present our experience of this flap for various soft tissue reconstructions. Between February 1993 and December 2002, 34 patients (22 males and 12 females) with various soft tissue defects received free arterialized venous flap reconstructions. The age ranged from 10 to 68 (mean:35.9) years-old. Free venous flaps of an afferent A-V fistula (A-V-V, type Ⅲ) were used in 23 patients, and flaps of total arterialized venous perfusion (A-V-A, type Ⅵ) were used in 11 patients. The size of the flaps ranged from 2×1 to 15×6 cm^2. Twenty-four flaps (70.6%) survived totally. Seven flaps (20.6%) survived with partial loss, in which only one flap needed the STSG for the wound coverage, and the other 6 flaps healed secondarily. All type IV venous flaps (11/11, 100%) survived; however only 87% (20/23) of the type Ⅲ flaps survived. The overall survival rate was 91.2%. There were three flap losses (8.8%) because of the severe venous congestion. Thirty flaps (88.2%) demonstrated different degrees of venous congestion postoperatively. Despite the postoperative venous congestion, the free arterialized venous flaps are useful for small and thin defects. They are especially useful for conditions that need both vascular conduit and soft tissue coverage.