Objective To investigate the operative procedure and the short-term therapeutic effects of medial plantar venous flaps for estoration of soft-tissue defects on the volar aspect of fingers. Methods From May 2007 to July 2009, 13 cases (15 fingers) of volar soft tissue defects were treated with medial plantar venous flaps, including 7 males (9 fingers) and 6 females(6 fingers) with an average age of 30 years (range, 17-55 years). Soft tissue defects were caused by electric saws in 4 cases (5 fingers), by crush injury in 6 cases (6 fingers), and by burned scar removal in 3 cases (4 fingers). The size of soft tissue defects ranged from 1.0 cm × 0.9 cm to 5.8 cm × 3.3 cm, included 5 thumbs, 3 index fingers, 3 l ittle fingers, 2 ring fingers, and 2 middle fingers. The emergency surgical treatment was performed in 10 traumatic cases after 2 to 12 hours (4 hours on average); and the elective surgical treatment was performed in the other 3 cases of scar after burn. The 15 medial plantar venous flaps, with size of 1.0 cm × 1.0 cm to 6.0 cm × 3.5 cm, were harvested to restore defects. Of them, 12 venous flaps had 1 superficial vein and the other 3 had 2 veins; and the veins of 13 venous flaps bridged a single digital artery and the veins of the other 2 flaps bridged both arteries. The donor sites were sutured directly or were covered with skin graft. Results All 15 venous flaps survived completely, and the donor and reci pient sites healed by first intention. Eleven cases (11 fingers) were followed up for 2 to 12 months. The texture and color of the flaps were similar to those of adjacent normal skin with a satisfactory appearance. The two-point discrimination was 6-9 mm. According to criterion for joint junction of total active range of motion/total active range of flexion, the results were excellent in 10 cases and good in 1 case; the excellent and good rate was 100%. Conclusion The medial plantar venous flap has advantages of easy-to-operate, rich blood supply and high survival rate. So it is an ideal and rel iable choice for volar soft tissue defects of fingers.
To summarize the results of the free transplantation of anti-valve-inflow and pro-valveoutflow arterial ized venous flap in repairing soft tissue defect of fingers in emergency treatment. Methods From October 2002 to March 2007, 7 cases of soft tissue defects of fingers were repaired with arterial ized venous flaps. There were 6 males and 1 female, aged 17-46 years. Defect was caused by crush injury in 6 cases and by stab injury in 1 case. The interval between injuryand operation was 2-7 hours and the size of defects ranged from 3.0 cm × 2.0 cm to 6.0 cm × 3.5 cm. All defects were repaired by arterial ized free venous flap from the ipsilateral forearm, in which the proximal ends of veins were anastomosed to artery and vein of the finger. The donor site was directly sutured. Results Six cases of arterial ized venous flap survived completely and 1 case had partial superficial necrosis and healed with conservative management. The donor site healed by first intention. Postoperative follow-up ranged from 3 months to 4 years, the texture and the thickness of the flaps were satisfactory, only one presented partial pigment deposits because of superficial necrosis. No sclerosis, contracture and l imited range of motion occurred in all flaps. According to the evaluation criteria for upper l imb function issued by Hand Surgery Branch of Chinese Medical Association, the results were excellent in 3 cases and good in 4 cases. Conclusion It is an ideal method to repair soft tissue defect of fingers by using anti-valve-inflow and pro-valve-outflow arterial ized venous flap.
OBJECTIVE: To study the forms of microcirculation of arterialized venous flap. METHODS: Twenty New Zealand rabbits were equally divided into two groups, arterialized venous flap group (group A) and control group (group B). The microcirculatory haemodynamic of arterialized venous flap was studied through observation of transparent chamber in rabbit’s ears with aspecial TV set with manification of 1000. RESULTS: The blood of arterilized venous flap flowed through venule anastomosis and drained to another venule. CONCLUSION: It is the main form of microcirculation in early stage that blood flows from venule to draining venule by way of communicating networks between venules.
In order to investigate the survival mechanism and the role of venous drainage in arterialized venous skin flap, 60 rabbits’ ears were used for research and clinical application of the flap was performed subsequently in two cases. The rabbits were divided into 4 groups. Experimental group was standard arterialized venous skin flap, control 1 group was venous skin flap, control 2 group was arterialized venous skin flap with only one drainage vein and control 3 group was normal skin flap. The process of survival of the flaps was observed by hemodynamic and histological method. The results showed that there was no significant difference between standard arterialized venous skin flap and normal skin flap (P gt; 0.01). Two cases of arterialized venous skin flap survived completely. The conclusion were as follow: 1. the opening of collateral circulation between the veinlets was the main change of the microcirculation; 2. the blood flow of the graft was changed from unphysiological circulation to physiological circulation as the time elapsed and 3. amelioration of venous drainage was important in inproving the survival rate of arterialized vein graft.
The experiment was earied out on the a boomen of the whiterats. The epigastric vein wasarterialized by means of anastomcois with the femoral artery, lateral thoracic vein was reserved as aefferent vessel. The changes of hemorheology were mesured after arterialization, and were comparedwith the changes in the normal A-V skin flaps. The levels of platelet, aggreation, blood viscosityand plasma fibrinogen in arterialized vein flape were signmeantly higher than that in A-V flaps. ASa r...
Application of the island flap on the back of rabbit as a model, the central vessel and its anterior edge vein was perserved. We explored the features of the blood supply and the difference in the dependence of the recipient bed of pure venous flap, arteriolised venous flap and conventional flap. The result showed that the conventional flap and arteriloized venous flap could survive, but the pure venous flap could not. It was suggested that the pure venous flap was in an impending necrotic condition, therefore,the blood circulation of recipient bed and the rate of revascularization between the recipient bed and the flap seemed to play an important role in the survival of the flap.