The complicated role of venous drainage on the survival of arterialized venous flaps
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Weidong Weng1, Feng Zhang2, Bin Zhao1, Zhipeng Wu1, Weiyang Gao1, Zhijie Li1, Hede Yan1
1Department of Orthopedics (Division of Plastic and Hand Surgery), The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
2Division of Plastic Surgery, University of Mississippi Medical Center, Jackson, Mississippi, USA
Zhijie Li, email: firstname.lastname@example.org
Hede Yan, email: email@example.com
Keywords: arterialized venous flap, venous drainage, venous congestion, survival mechanism
Received: November 04, 2016 Accepted: January 17, 2017 Published: January 27, 2017
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.
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