title: Immediate and delayed use of arteriovenous fistulae in microsurgical flap procedures: a clinical series and review of published cases.
abstract: In microsurgical flap procedures, creation of an arteriovenous fistula (AVF) is a technique of vein grafting where the vein graft is connected to recipient vessels as a flow-through loop prior to harvest and inset of the flap. Controversy exists whether this technique can be used as a 2-stage procedure with the loop and flap transfer accomplished in sequential operations or if the loop and flap transfer should be performed in a single operation. We performed 12 consecutive 1-stage AVF-flap procedures, with 1 flap failure. We combined this series with previously published reports to compare outcomes of 1-stage and 2-stage procedures. We found no significant difference in flap outcomes or complication rates between the 2 strategies. We conclude from our experience and this analysis that single-stage AVF-flap procedures are the optimum application of this technique.
authors.affiliation: Division of Plastic Surgery, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS 39216, USA.
authors.forename: Tanya M
authors.initials: TM
authors.lastname: Oswald
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Stover
authors.forename: Jacob
authors.initials: J
authors.lastname: Gerzenstein
authors.forename: M P
authors.initials: MP
authors.lastname: Lei
authors.forename: Feng
authors.initials: F
authors.lastname: Zhang
authors.forename: Allen
authors.initials: A
authors.lastname: Muskett
authors.forename: Eric
authors.initials: E
authors.lastname: Hu
authors.forename: Michael F
authors.initials: MF
authors.lastname: Angel
authors.forename: William C
authors.initials: WC
authors.lastname: Lineaweaver
mesh_terms: D000293:Adolescent; D000328:Adult; D001163:Arteriovenous Anastomosis; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*; D013997:Time Factors