Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Muellner Hauptstrasse 48, A-5020 Salzburg, Austria.
Department of Oral and Maxillofacial Surgery, Queen Victoria Hospital, Holtye Road, East Grinstead, RH19 3DZ, United Kingdom.
Sci Rep. 2016 Aug 25;6:31970. doi: 10.1038/srep31970.
In arterialized venous flaps (AVFs) the venous network is used to revascularize the flap. While the feasibility of AVFs in soft tissues has been reported there is no study on osseous AVFs. In this study we aim to assess the flap survival of osseous AVFs in a pig model. Medial femoral condyle flaps were elevated in 18 pigs. Three groups were created: AVF (n = 6), conventional arterial flap (cAF, n = 6) and bone graft (BG, n = 6). The AVFs were created by anastomosis of genicular artery with one vena comitans while leaving one efferent vein for drainage. After 6 months the specimens were harvested. The histology and histomorphometry of of the bone in cAF and AVF was significantly superior to bone grafts with a higher bone volume in AVFs (p = 0.01). This study demonstrates that osseous free flaps may be supported and survive using the technique of arterialization of the venous network. The concept of AVFs in osseous flaps may be feasible for revascularization of free flaps with an inadequate artery but well developed veins. Further experimental and clinical studies are needed to assess the feasibility of clinical use of arterialized venous bone flaps.
在动脉化静脉皮瓣（AVF）中，静脉网络用于为皮瓣重新提供血液供应。虽然已经有关于软组织中 AVF 的可行性的报道，但对于骨 AVF 尚无研究。在本研究中，我们旨在评估猪模型中骨 AVF 的皮瓣存活率。在 18 头猪中掀起股骨内侧髁皮瓣。创建了三组：AVF（n=6）、常规动脉皮瓣（cAF，n=6）和骨移植物（BG，n=6）。通过将关节动脉与一条伴行静脉吻合来创建 AVF，同时保留一条流出静脉用于引流。6 个月后收获标本。cAF 和 AVF 的骨组织学和组织形态计量学明显优于骨移植物，AVF 中的骨体积更高（p=0.01）。这项研究表明，使用静脉网络动脉化的技术可以支持和维持骨游离皮瓣。AVF 的概念对于动脉供血不足但静脉发育良好的游离皮瓣的再血管化可能是可行的。需要进一步的实验和临床研究来评估动脉化静脉骨瓣临床应用的可行性。
