Arterialized venous flap is defined as a skin flap, which has arterial inflow through an afferent vein perfusing the flap and then venous outflow through the efferent veins. The main advantage of an arterialized venous flap is the ease of harvesting a thin flap without the need to sacrifice a major artery at the donor site.
A retrospective 11-year period (1993-2004) study was performed of 152 patients with 154 arterialized venous flaps for reconstruction of hand defects. The average age of the patients was 35 years and the mean follow-up period was 28 months. The authors classified the venous flaps based on their size and composition. According to their size, flaps smaller than 10 cm2 were classified as small, flaps larger than 25 cm2 were classified as large, and those in between were classified as medium. Flaps were also classified according to their composition, including: venous skin flaps, innervated venous flaps, tendocutaneous venous flaps, conduit venous flaps to repair arterial defects, and composite venous flaps. The authors report a success rate of 98% with a 5 % partial flap necrosis rate. The innervated venous flaps were found to have acceptable two-point discrimination or had development of protective sensation.
The authors conclude that the arterialized venous flap indications should be expanded to not just the smaller hand defects but larger sized defects as well. Composite defects of nerve, tendon, and vessels can be reconstructed with this technique with the main advantages are being thin and leaving minimal donor-site morbidity. In experienced hands, this may be a useful flap for microsurgical reconstruction of composite defects of the hand.
Flaps, Arterialized, Venous, Hand, Reconstruction
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