Agarwal Pawan, Kumar Ambuj, Sharma Dhananjaya
Plastic Surgery Unit, Department of Surgery, N.S.C.B. Government Medical College, Jabalpur 482003, M.P., India.
J Clin Orthop Trauma. 2016 Oct-Dec;7(Suppl 2):150-153. doi: 10.1016/j.jcot.2016.11.001. Epub 2016 Nov 15.
venous flaps are alternative reconstructive option for coverage of defects. They are nourished by venous blood flow or by arterial blood flowing through the venous network. This study was conducted to assess the feasibility of venous flap in coverage of extremities defects following trauma and burns.
Over a period of one year, 15 arterialized venous flaps were applied to skin defects of the hand. Postoperatively flap were monitored for survival and patients followed up for three months.
In patients with flap area ranging from 6 to 10 cm, all the 6 patients have complete survival (100%). In 11-15 cm group 3 out of 5 patients have complete survival (60%) and 2 have partial survival (40%). In 16-20 cm group 1 out of 3 have complete survival (33.3%) and 2 have partial survival (66.6%). In 21-25 cm group there was only 1 patient who had complete necrosis. This study suggests that small venous flaps have better survival rate as compared to large flaps. Variable degree of congestion was present in all the patients in first post operative week which gradually disappeared in second week.
The venous flap is good alternate for reconstruction of the small defects of hand and digits. It is easy to designed and harvest. It is thin and pliable, without need to sacrifice a major artery at the donor site and with no limitation on the donor site.
静脉皮瓣是覆盖缺损的一种替代性重建选择。它们由静脉血流或通过静脉网络流动的动脉血滋养。本研究旨在评估静脉皮瓣覆盖创伤和烧伤后肢体缺损的可行性。
在一年的时间里，对15例手部皮肤缺损应用了动脉化静脉皮瓣。术后监测皮瓣存活情况，并对患者进行了三个月的随访。
皮瓣面积在6至10厘米的患者中，6例患者全部完全存活（100%）。在11至15厘米组的5例患者中，3例完全存活（60%），2例部分存活（40%）。在16至20厘米组的3例患者中，1例完全存活（33.3%），2例部分存活（66.6%）。在21至25厘米组中，只有1例患者完全坏死。本研究表明，与大皮瓣相比，小静脉皮瓣的存活率更高。术后第一周所有患者均出现不同程度的充血，第二周逐渐消失。
静脉皮瓣是手部和手指小缺损重建的良好替代方法。它易于设计和切取。它薄且柔韧，无需在供区牺牲主要动脉，且供区无限制。
