Arterialized Venous Bone Flaps: An Experimental Investigation.

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Citation: Scientific Reports. 6:31970, 2016 08 25PMID: 27558705Institution: Curtis National Hand CenterForm of publication: Journal ArticleMedline article type(s): Journal Article | Research Support, Non-U.S. Gov'tSubject headings: *Bone and Bones/pa [Pathology] | *Surgical Flaps/bs [Blood Supply] | *Veins/ph [Physiology] | Animals | Arteriovenous Shunt, Surgical | Bone and Bones/su [Surgery] | Bone Transplantation | Graft Survival | Swine | Veins/su [Surgery]Year: 2016ISSN:
  • 2045-2322
Name of journal: Scientific reportsAbstract: 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.All authors: Benlidayi ME, Borumandi F, Buerger H, Gaggl A, Higgins JP, Sencar L, Vasilyeva AFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2018-05-08
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Journal Article MedStar Authors Catalog Article 27558705 Available 27558705

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.

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