Pedicled and "flow-through" venous flaps: clinical applications.

Area of Science:

• Plastic and Reconstructive Surgery
• Vascular Surgery
• Microsurgery

Background:

• Pedicled venous flaps and "flow-through" venous flaps are gaining attention for treating skin defects in the fingers and hands.
• Previous approaches included preserving draining veins, "flow-through" veins, or arterialized "flow-through" flaps.

Observation:

• Venous blood is crucial for flap survival.
• Measurements of venous pressure in the finger and elbow, along with venographies of the finger and hand, were conducted.
• The study focused on pedicled venous flaps and "flow-through" venous flaps, excluding arterialized flaps.

Findings:

• Essential conditions for successful venous flap procedures include using flaps with rich venous networks and preserving numerous "flow-through" veins.
• Harvesting a pedicled venous flap requires attention to afferent (reversed) venous pressure.
• Anastomosing "flow-through" flaps necessitates recipient veins with high efferent venous pressure and observed differential pressure.

Implications:

• Understanding these conditions can improve the success rate of venous flap surgeries for hand and finger reconstruction.
• The study identifies previously unrecognized causes of flap failure, offering insights for surgical technique refinement.
• This research provides a basis for establishing optimal conditions for harvesting and utilizing venous flaps in reconstructive surgery.