Pre-arterialisation of an arterialised venous flap: clinical cases

Many factors affecting the survival of arterialised venous flaps have been elucidated, both experimentally and clinically. The survival of large arterialised venous flaps has been reported, with varying results. Large arterialised venous flaps with preformed arteriovenous fistulae at the donor sites have been successfully performed in experimental animals. We report the results of repair of skin defects in the extremities with arterialised venous flaps in eight patients. The arteriovenous shunts were created at the donor sites at least 2 weeks before the flaps were harvested. The flap sizes ranged between 4 x 4cm and 9 x 10 cm. Flap survival was between 93% and 100% of the surface area, as shown by digitalised scanning. In addition to the known advantages of venous flaps, such as less bulk, preservation of the main arteries and ease of harvesting, pre-arterialisation makes designing the flap easier due to the noticeable superficial veins. Pre-arterialisation, when used in carefully selected cases, did not prolong the hospital course of the patients.