Oswald Tanya M, Stover Stephanie A, Gerzenstein Jacob, Lei M P, Zhang Feng, Muskett Allen, Hu Eric, Angel Michael F, Lineaweaver William C
Division of Plastic Surgery, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS 39216, USA.
Ann Plast Surg. 2007 Jan;58(1):61-3. doi: 10.1097/01.sap.0000250743.78576.35.
In microsurgical flap procedures, creation of an arteriovenous fistula (AVF) is a technique of vein grafting where the vein graft is connected to recipient vessels as a flow-through loop prior to harvest and inset of the flap. Controversy exists whether this technique can be used as a 2-stage procedure with the loop and flap transfer accomplished in sequential operations or if the loop and flap transfer should be performed in a single operation. We performed 12 consecutive 1-stage AVF-flap procedures, with 1 flap failure. We combined this series with previously published reports to compare outcomes of 1-stage and 2-stage procedures. We found no significant difference in flap outcomes or complication rates between the 2 strategies. We conclude from our experience and this analysis that single-stage AVF-flap procedures are the optimum application of this technique.
在显微外科皮瓣手术中，动静脉瘘（AVF）的创建是一种静脉移植技术，在皮瓣切取和植入之前，将静脉移植物作为一个流通环连接到受区血管。对于该技术是应作为一种分两阶段的手术，即先完成动静脉瘘环的构建，再进行皮瓣转移，还是应在一次手术中同时完成动静脉瘘环构建和皮瓣转移，目前存在争议。我们连续进行了12例一期动静脉瘘-皮瓣手术，其中1例皮瓣失败。我们将该系列病例与之前发表的报告相结合，以比较一期和二期手术的结果。我们发现这两种策略在皮瓣结果或并发症发生率方面没有显著差异。基于我们的经验和分析，我们得出结论，一期动静脉瘘-皮瓣手术是该技术的最佳应用方式。
