Two-Stage Arterialized Flow-Through Venous Flap Transfer for Third-Degree Burn Defects on the Dorsum of the Hand

Yasuo Ueda; Shigeru Mizumoto; Toshiyuki Hirai; Yasushi Doi; Akihiro Fukui; Susumu Tamai

doi:10.1055/s-2007-1006429

Journal of Reconstructive Microsurgery, Inhaltsverzeichnis

J Reconstr Microsurg 1997; 13(7): 489-496
DOI: 10.1055/s-2007-1006429

ORIGINAL ARTICLE

Two-Stage Arterialized Flow-Through Venous Flap Transfer for Third-Degree Burn Defects on the Dorsum of the Hand

Yasuo Ueda, Shigeru Mizumoto, Toshiyuki Hirai, Yasushi Doi, Akihiro Fukui, Susumu Tamai

Departments of Orthopedic Surgery, National Insurance Union Medical Center of Nara, Nara Prefectural Critical Care Medical Center, and Nara Medical University

Abstract

ABSTRACT

A modified, two-stage arteriovenous flow-through venous flap was designed to repair skin defects due to third-degree burns on the dorsum of the hand in four patients. Two weeks after plasty of an arteriovenous (A-V) shunt between the greater saphenous vein and dorsalis pedis artery, the arterialized flow-through venous flap was transferred using the greater saphenous vein as the pedicle. The size of the flaps utilized ranged from 7 × 13 cm to 9 × 13 cm. In three patients the entire flap survived without complication. In one patient whose flap had only one drainage vein, the flap survived with superficial necrosis of about 10 percent of the flap at the borders. During the 2 weeks after A-V shunt creation, the authors believe that microcirculation around the arterialized vein probably develops, contributing to better irrigation and thereby to flap survival. Using this two-stage procedure, it might be feasible to obtain larger grafts and to attain a higher flap survival rate.

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