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Arterialized venous flaps for reconstructing soft-tissue defects of the extremities
1Department of Plastic and Reconstructive Surgery, Eastern Virginia Medical School, Norfolk, Va.
Plastic and Reconstructive Surgery
|December 1, 1994
Summary
Free venous fasciocutaneous flaps offer a viable solution for soft-tissue defects, utilizing only a venous pedicle for arterial inflow. This technique successfully covers extremity defects without sacrificing a donor artery.
Area of Science:
- Plastic Surgery
- Vascular Surgery
- Reconstructive Surgery
Background:
- Soft-tissue defects in extremities often require complex reconstructive solutions.
- Free fasciocutaneous flaps are a common method, typically relying on arterial inflow.
- Alternative methods preserving donor arteries are sought after.
Observation:
- Four cases of extremity soft-tissue defects were treated using free fasciocutaneous venous free flaps.
- Arterial inflow for these flaps relied exclusively on the venous pedicle.
- Cadaver studies confirmed the subdermal venous plexus as the sole supply to the cutaneous island.
Findings:
- Flap sizes ranged from 4x6 cm to 5x9 cm.
- Three of the four flaps achieved complete survival.
- One flap experienced partial loss of its cutaneous island, though subcutaneous tissue survived.
Implications:
- Free venous fasciocutaneous flaps represent a successful reconstructive option for extremity defects.
- This technique avoids the sacrifice of a donor artery, preserving vascular resources.
- While the immediate postoperative period presents a tenuous blood supply, successful transfer is achievable.