title: Concept of arteriovenous loupes in high-risk free-tissue transfer: history and clinical experiences.
abstract: The present study describes the concepts of arteriovenous (A-V) loupes prior to microsurgical free flap transfer in a selected high-risk group of patients. A one-stage concept was employed in 26 patients; 5 patients underwent two-stage flap transfer. Seven thrombotic occlusions of the A-V fistula or flap vessels were recorded; 6 patients underwent successful revision. Overall flap survival was 96.8% and compared favorably to reports in the literature. Defect coverage could be achieved in all but one case. It can be concluded from the data that in selected high-risk patient groups, i.e., following radiation, compound trauma, chronic infection, or multiple comorbidities, the creation of an A-V fistula prior to flap transfer may facilitate innovative reconstructive solutions.
authors.affiliation: Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center, University of Heidelberg, Ludwigshafen, Germany. sbruener@yahoo.com
authors.forename: Simone
authors.initials: S
authors.lastname: Brüner
authors.forename: Berthold
authors.initials: B
authors.lastname: Bickert
authors.forename: Michael
authors.initials: M
authors.lastname: Sauerbier
authors.forename: Günter
authors.initials: G
authors.lastname: Germann
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000266:history / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply; D013997:Time Factors