A novel rabbit model for the evaluation of retrograde flow venous flaps

Venous flaps have several potential advantages over traditional flaps, but their uses have been limited by unpredictable survival. Although clinical and experimental studies have concentrated mainly on the antegrade arterialization of venous flaps to increase survival, retrogradely arterialized venous flaps (AVFs) may have the greatest potential. There is, however, little literature on their use. There are also no animal studies comparing their survival to other venous flaps used in a similar situation. Our aim was to design a flap utilizing the rabbit's valved, thoracoepigastric vein (consisting of the lateral thoracic and epigastric veins) as the source vessel for the study of retrograde arterialized venous flaps (RAVFs). A pilot study (n = 10) to determine the survival of RAVFs was performed utilizing this animal model. Four flaps had complete survival at the end of our 2-week observational period. However, we also had four partial flap losses and two cases in which the entire flap was lost. An average survival area of 44.5% was observed. In conclusion, our designed rabbit thoracoepigastric RAVF is simple to apply and easily reproducible. It is the first animal flap adapted specifically for the study of RAVFs, and may be used for the further investigation of these flaps, which have shown unpredictable survival to date.