The arterialized saphenous venous flow-through flap with dual venous drainage

Warren Rozen, Jeannette Ting, Robert Gilmour, James Chin Sek Leong

Research output: Contribution to journalArticleResearchpeer-review

Abstract

BACKGROUND: Venous flow-through flaps are well-described options for small defects where donor site morbidity is undesirable or in areas where useful local veins are in close proximity to the defect, particularly in the extremities. However, higher rates of flap loss have limited their utility. The saphenous venous flap in particular has been widely sought as a useful flap, and while arterialization of this flap improved survival rates, congestion has remained a limiting feature. We describe report a modification in the design of saphenous venous flaps, whereby an arterialized flap is provided with a separate source of venous drainage, and demonstrate survival of substantially larger venous flaps than previously reported. METHODS: In five consecutive patients, we describe three main modifications to the saphenous venous flap as previously described: (a) Using arterialized flaps only; (b) Reversing the flap to allow unimpeded flow during arterialization; and (c) Anastomosing additional vein(s) that are not connected to the central vein-especially at the periphery of the flap for true venous drainage. RESULTS: There was a 0 complete flap loss rate (with only one case of superficial partial loss), and ultimately better survival than previous series of saphenous venous flaps described to date. CONCLUSION: The success of these techniques offers the potential to re-establish flow to large segmental losses to axial arteries, offer safe and definitive flap coverage to traumatic wounds, improve the array of flap options in this setting, and minimize donor site morbidity.
Original languageEnglish
Pages (from-to)281 - 288
Number of pages8
JournalMicrosurgery
Volume32
Issue number4
DOIs
Publication statusPublished - 2012

Cite this

Rozen, Warren ; Ting, Jeannette ; Gilmour, Robert ; Leong, James Chin Sek. / The arterialized saphenous venous flow-through flap with dual venous drainage. In: Microsurgery. 2012 ; Vol. 32, No. 4. pp. 281 - 288.
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title = "The arterialized saphenous venous flow-through flap with dual venous drainage",
abstract = "BACKGROUND: Venous flow-through flaps are well-described options for small defects where donor site morbidity is undesirable or in areas where useful local veins are in close proximity to the defect, particularly in the extremities. However, higher rates of flap loss have limited their utility. The saphenous venous flap in particular has been widely sought as a useful flap, and while arterialization of this flap improved survival rates, congestion has remained a limiting feature. We describe report a modification in the design of saphenous venous flaps, whereby an arterialized flap is provided with a separate source of venous drainage, and demonstrate survival of substantially larger venous flaps than previously reported. METHODS: In five consecutive patients, we describe three main modifications to the saphenous venous flap as previously described: (a) Using arterialized flaps only; (b) Reversing the flap to allow unimpeded flow during arterialization; and (c) Anastomosing additional vein(s) that are not connected to the central vein-especially at the periphery of the flap for true venous drainage. RESULTS: There was a 0 complete flap loss rate (with only one case of superficial partial loss), and ultimately better survival than previous series of saphenous venous flaps described to date. CONCLUSION: The success of these techniques offers the potential to re-establish flow to large segmental losses to axial arteries, offer safe and definitive flap coverage to traumatic wounds, improve the array of flap options in this setting, and minimize donor site morbidity.",
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The arterialized saphenous venous flow-through flap with dual venous drainage. / Rozen, Warren; Ting, Jeannette; Gilmour, Robert; Leong, James Chin Sek.

In: Microsurgery, Vol. 32, No. 4, 2012, p. 281 - 288.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The arterialized saphenous venous flow-through flap with dual venous drainage

AU - Rozen, Warren

AU - Ting, Jeannette

AU - Gilmour, Robert

AU - Leong, James Chin Sek

PY - 2012

Y1 - 2012

N2 - BACKGROUND: Venous flow-through flaps are well-described options for small defects where donor site morbidity is undesirable or in areas where useful local veins are in close proximity to the defect, particularly in the extremities. However, higher rates of flap loss have limited their utility. The saphenous venous flap in particular has been widely sought as a useful flap, and while arterialization of this flap improved survival rates, congestion has remained a limiting feature. We describe report a modification in the design of saphenous venous flaps, whereby an arterialized flap is provided with a separate source of venous drainage, and demonstrate survival of substantially larger venous flaps than previously reported. METHODS: In five consecutive patients, we describe three main modifications to the saphenous venous flap as previously described: (a) Using arterialized flaps only; (b) Reversing the flap to allow unimpeded flow during arterialization; and (c) Anastomosing additional vein(s) that are not connected to the central vein-especially at the periphery of the flap for true venous drainage. RESULTS: There was a 0 complete flap loss rate (with only one case of superficial partial loss), and ultimately better survival than previous series of saphenous venous flaps described to date. CONCLUSION: The success of these techniques offers the potential to re-establish flow to large segmental losses to axial arteries, offer safe and definitive flap coverage to traumatic wounds, improve the array of flap options in this setting, and minimize donor site morbidity.

AB - BACKGROUND: Venous flow-through flaps are well-described options for small defects where donor site morbidity is undesirable or in areas where useful local veins are in close proximity to the defect, particularly in the extremities. However, higher rates of flap loss have limited their utility. The saphenous venous flap in particular has been widely sought as a useful flap, and while arterialization of this flap improved survival rates, congestion has remained a limiting feature. We describe report a modification in the design of saphenous venous flaps, whereby an arterialized flap is provided with a separate source of venous drainage, and demonstrate survival of substantially larger venous flaps than previously reported. METHODS: In five consecutive patients, we describe three main modifications to the saphenous venous flap as previously described: (a) Using arterialized flaps only; (b) Reversing the flap to allow unimpeded flow during arterialization; and (c) Anastomosing additional vein(s) that are not connected to the central vein-especially at the periphery of the flap for true venous drainage. RESULTS: There was a 0 complete flap loss rate (with only one case of superficial partial loss), and ultimately better survival than previous series of saphenous venous flaps described to date. CONCLUSION: The success of these techniques offers the potential to re-establish flow to large segmental losses to axial arteries, offer safe and definitive flap coverage to traumatic wounds, improve the array of flap options in this setting, and minimize donor site morbidity.

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