Augmentation of Venous Drainage by a Venous Anastomosis for Pedicled Flaps

Sukru Yazar; Hung-Chi Chen; Samir Mardini

doi:10.1055/s-2008-1080531

Journal of Reconstructive Microsurgery, Table of Contents

J Reconstr Microsurg 2008; 24(5): 369-376
DOI: 10.1055/s-2008-1080531

Augmentation of Venous Drainage by a Venous Anastomosis for Pedicled Flaps

Sukru Yazar¹ , Hung-Chi Chen¹ , Samir Mardini¹

¹Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taipei, Taiwan, Republic of China

Abstract

ABSTRACT

Recently several studies have addressed the venous problem and confirmed that venous ischemia is more injurious to tissue viability than arterial ischemia of equivalent duration. There are different methods of managing venous-compromised pedicled flaps. Between June 1996 and November 2003, our center treated two submental, five Becker, nine posterior interosseous, three distally based sural, and three colon pedicled flaps (22 flaps in total), which had venous congestion either at the time of flap elevation or immediately after inset of the flap. These cases of venous congestion were managed with an immediate additional venous anastamosis. After vein anastomosis, venous congestion reduced gradually, then improved, and finally disappeared completely in the postoperative follow-up days with all flaps surviving in their entirety. Reexploration was not required for the microsurgical venous anastomosis. In conclusion, flap necrosis resulting from venous congestion causes prolonged hospitalization, multiple debridements, and additional procedures to cover the exposed structures. Additional vein anastomosis, which is a simple, rapid, and reliable auxiliary procedure, may increase complete flap survival and lead to successful end results, both functional and cosmetic.

KEYWORDS

Pedicled flaps - venous congestion - additional vein anastomosis

Full Text

References

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Sukru YazarM.D.

Sancaktar Tekkesi Sok., Fen Apt. No. 37/29

34310 Kocamustafapasa, Istanbul, Turkey