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Arterialized venous flow-through flaps in the reconstruction of digital defects: case series and review of the literature

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HAND

Abstract

Background

Arterialized venous flow-through (AVFT) flaps are useful in reconstructing small soft tissue defects. Currently, no guidelines exist for the use of AVFT flaps for reconstructing soft tissue defects in the digits of the hand. We retrospectively reviewed our experience with AVFT flaps and developed a selection process for vascular anastomoses.

Methods

We reviewed the use of AVFT flaps in a series of ten consecutive patients requiring reconstruction of small soft tissue defects of the fingers.

Results

Between 2006 and 2012, ten consecutive digital reconstructions were performed using AVFT flaps. Flap sizes ranged from 5 to 13.5 cm2. Initial congestion was seen in all flaps and resolved within 3–7 days. Leeches were utilized in two cases. All cases achieved good functional results. Three illustrative cases from our series of ten are presented, each demonstrating key decision-making factors in selecting recipient and flap vessels for anastomosis.

Conclusions

AVFT flaps appear congested post-operatively, resolving in days to weeks, and resulting in healthy coverage of digital soft tissue defects with good functionality. We suggest a selection process for the use of AVFT flaps in digital soft tissue reconstruction, based on dorsal vs. volar and proximal vs. distal defect location, and the flap’s inherent venous architecture.

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Acknowledgments

All schematic drawings (Figs. 1d, 2d, 3c, and 4) were drawn by author JG.

Grant Support

None

Conflict of Interest

Jared W. Garlick declares that he has no conflict of interest.

Isak A. Goodwin declares that he has no conflict of interest.

Keith Wolter declares that he has no conflict of interest.

Jayant P. Agarwal declares that he has no conflict of interest.

Statement of Human and Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Statement of Informed Consent

This study was submitted to our institutional IRB and received exempt status.

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Authors and Affiliations

  1. Division of Plastic Surgery, University of Utah Health Sciences Center, 30 North 1900 East, 3B400, Salt Lake City, UT, 84132, USA

    Jared W. Garlick, Isak A. Goodwin & Jayant P. Agarwal

  2. Department of Surgery, Plastic Surgery Section, University of Arkansas for Medical Sciences, 4301 W. Markham St. #720, Little Rock, AR, 72205, USA

    Keith Wolter

Authors
  1. Jared W. Garlick
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  2. Isak A. Goodwin
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  3. Keith Wolter
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  4. Jayant P. Agarwal
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Corresponding author

Correspondence to Jayant P. Agarwal.

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Garlick, J.W., Goodwin, I.A., Wolter, K. et al. Arterialized venous flow-through flaps in the reconstruction of digital defects: case series and review of the literature. HAND 10, 184–190 (2015). https://doi.org/10.1007/s11552-014-9684-0

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  • DOI: https://doi.org/10.1007/s11552-014-9684-0

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