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Arteriovenous fistula and skin flaps
1Department of Plastic and Reconstructive Surgery, Fatih University School of Medicine, Ankara, Turkey.
Journal of Reconstructive Microsurgery
|November 24, 1999
Summary
Arteriovenous fistulas (AVF) can compromise skin flap survival. However, strategic placement of the AVF, as demonstrated in Group 2, can prevent flap necrosis and ensure complete survival in this rat model.
Area of Science:
- Plastic Surgery
- Vascular Surgery
- Experimental Surgery
Background:
- Skin flap viability is crucial in reconstructive surgery.
- Arteriovenous fistulas (AVF) can alter local hemodynamics, potentially impacting flap survival.
- Understanding the relationship between AVF and flap perfusion is essential for surgical planning.
Purpose of the Study:
- To investigate the effects of an arteriovenous fistula (AVF) on the viability of island and peninsular groin flaps in a rat model.
- To determine if the anatomical location of an AVF relative to the flap pedicle influences flap survival.
Main Methods:
- An experimental study was conducted on rats using a groin flap model.
- Animals were divided into three groups, with variations in flap type (island vs. peninsular) and AVF creation.
- AVFs were created by side-to-side anastomosis proximal to the flap pedicle at the common femoral vessels.
Main Results:
- Island groin flaps with an AVF demonstrated complete failure and necrosis.
- Peninsular flaps with the AVF base on the lower extremity side (Group 3) showed severe blood flow reduction and total flap loss.
- Peninsular flaps with the AVF base on the rectus side (Group 2) survived completely without complications.
Conclusions:
- An AVF proximal to the flap pedicle negatively impacts island skin flap circulation and viability.
- Strategic anatomical positioning of the AVF, as achieved in Group 2, can overcome reduced blood flow and prevent flap necrosis in this experimental model.