Abstract
The arterialized venous flap (AVF) has been gradually popularized in clinical settings; however, its survival is still inconsistent and the role of venous drainage remains elusive. In this study, we aimed to investigate the role of venous drainage on the flap survival of arterialized venous flaps. An arterialized venous flap was outlined symmetrically in the rabbit abdomen. The arterial perfusion flap with a unilateral vascular pedicle was taken as the control group and three other experimental groups (I, II and III) were designed based on the number of drainage veins (n = 1, 2 and 3 in the three groups, respectively). Compared with the control group, significant venous congestion was noted in all the experimental groups and the most severe one was seen in group I; while no statistical difference was observed between groups II and III. Similar results regarding blood perfusion state, epidermal metabolite levels and flap survival status were obtained among the three groups. These findings suggested that venous drainage is vital in the survival of the flap, but unlike in the arterial perfusion flaps, the problem of venous congestion can only be partially solved by increasing the number of draining veins. Further studies are warranted to gain insight into this complicated issue.
Highlights
With the increasing aesthetic demands in plastic and reconstructive surgeries, the development of thin flaps with high quality has gained great interest in recent years [1] .A variety of flaps have been designed and utilized in clinical practice for resurfacing different kinds of soft tissue defects; only a few flaps are well accepted in terms of aesthetic concerns [2, 3]
We aimed to investigate the role of venous drainage on the flap survival of arterialized venous flaps
These findings suggested that venous drainage is vital in the survival of the flap, but unlike in the arterial perfusion flaps, the problem of venous congestion can only be partially solved by increasing the number of draining veins
Summary
With the increasing aesthetic demands in plastic and reconstructive surgeries, the development of thin flaps with high quality has gained great interest in recent years [1] .A variety of flaps have been designed and utilized in clinical practice for resurfacing different kinds of soft tissue defects; only a few flaps are well accepted in terms of aesthetic concerns [2, 3]. The arterialized venous flap (AVF) is one of the flaps that can meet the aesthetic needs in plastic and reconstructive surgeries based on the advantages of being non- bulky, ease of design and harvest, no limitation of the donor sites, and less donor-site morbidity [4]. AVFs, as a non-physiological flap, still suffer from a high partial or even total flap loss rate in literature, especially for the reconstruction of relatively large defects [5, 6]. The philosophy of this phenomenon is still unclear. We aim to investigate the role of venous drainage on the survival of AVFs in rabbits, attempting to develop a possible strategy on survival improvement of this flap
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