Immediate and delayed use of arteriovenous fistulae in microsurgical flap procedures: a clinical series and review of published cases.
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.
Oswald
Tanya M
TM
Division of Plastic Surgery, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS 39216, USA.
Stover
Stephanie A
SA
Gerzenstein
Jacob
J
Lei
M P
MP
Zhang
Feng
F
Muskett
Allen
A
Hu
Eric
E
Angel
Michael F
MF
Lineaweaver
William C
WC
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