A few considerations regarding enhancement of arterialized skin flap survival

An arterialized skin flap is defined as a flap harvested from the anterior and distal third of the forearm over a venous pathway. It is composed essentially of skin, subcutaneous tissue, and the subdermal plexus of the veins. The flap is perfused at the recipient side by a donor artery at one end and is connected to one or more regional veins at the opposite end. Since it depends on an atypical blood perfusion, leading to edema, epidermolysis, or even some degree of skin necrosis during the immediate postoperative procedure, this skin flap is considered to have a torpid evolution. This article includes some considerations regarding the enhancing of the arterialized skin flap survival, based on our clinical and laboratory experience after its transplantation. The design, construction of its arterial afferent phase, construction of its venous efferent phase, and monitoring are discussed.