Ueda Y, Mizumoto S, Hirai T, Doi Y, Fukui A, Tamai S
Department of Orthopedic Surgery, National Insurance Union Medical Center of Nara, Japan.
J Reconstr Microsurg. 1997 Oct;13(7):489-96. doi: 10.1055/s-2007-1006429.
A modified, two-stage arteriovenous flow-through venous flap was designed to repair skin defects due to third-degree burns on the dorsum of the hand in four patients. Two weeks after plasty of an arteriovenous (A-V) shunt between the greater saphenous vein and dorsalis pedis artery, the arterialized flow-through venous flap was transferred using the greater saphenous vein as the pedicle. The size of the flaps utilized ranged from 7 x 13 cm to 9 x 13 cm. In three patients the entire flap survived without complication. In one patient whose flap had only one drainage vein, the flap survived with superficial necrosis of about 10 percent of the flap at the borders. During the 2 weeks after A-V shunt creation, the authors believe that microcirculation around the arterialized vein probably develops, contributing to better irrigation and thereby to flap survival. Using this two-stage procedure, it might be feasible to obtain larger grafts and to attain a higher flap survival rate.
设计了一种改良的两阶段动静脉血流通过静脉皮瓣，用于修复4例手部背部三度烧伤所致的皮肤缺损。在大隐静脉与足背动脉之间建立动静脉（A-V）分流2周后，以大隐静脉为蒂转移动脉化血流通过静脉皮瓣。所使用皮瓣的大小范围为7×13 cm至9×13 cm。3例患者的皮瓣全部存活，无并发症。1例患者的皮瓣只有一条引流静脉，皮瓣存活，但边缘约10%的皮瓣发生浅表坏死。作者认为，在建立动静脉分流后的2周内，动脉化静脉周围可能会形成微循环，有助于更好地进行灌注，从而提高皮瓣存活率。采用这种两阶段手术方法，有可能获得更大的移植皮瓣并实现更高的皮瓣存活率。
