Effect of arteriovenous fistula on wound healing and skin blood flow

In dogs, the tension in a surgical incision and a measure of subcutaneous blood flow were obtained adjacent and distal to a groin arteriovenous (A-V) fistula. At 7 days, in the fistula-bearing leg compared with the control there was an increased force required to separate the wound edges adjacent to the fistula, while the opposite was true for the distal incision. Radioxenon washout, used for a measure of subcutaneous blood flow, was more rapid distally in the control leg. In the fistula leg this relationship was reversed. These studies indicate there is a redistribution of blood in the leg when an A-V fistula is constructed, with augmented subcutaneous flow and increased wound strength adjacent to the fistula and the converse at a distal site in the limb.