title: Effects of short-term venous augmentation on the improvement of flap survival: an experimental study in rats.
abstract: BACKGROUND
  Flap necrosis due to blood circulation disorders is a serious problem in reconstructive surgery. Methods to achieve both arterial and venous microvascular augmentation at the flap periphery have therefore been developed to prevent post-surgical circulation problems, especially for large pedicle flaps and free flaps containing three more vascular territories. Moreover, the benefits of microvascular venous augmentation (VA; superdrainage) alone have been established, but the optimal duration of post-surgical venous drainage has not yet been determined.
  
  
  METHODS
  The surviving flap area was compared after standard and short-term VA in the extended island flap model of the rat abdomen. A flap model using the left superficial inferior epigastric artery/vein as the vascular pedicle was used as a control group (n = 6). The lateral branch of the right superficial inferior epigastric vein remained unresected at the end of the flap in the VA group (n = 7), but was ligated at 24 h post-surgery in the temporary venous augmentation (TVA) group (n = 7).
  
  
  RESULTS
  The flap survival rates on postoperative day 7 in the control, VA and TVA groups were 74.8 ± 8.4%, 90.1 ± 3.7% and 89.9 ± 3.5%, respectively. The surviving areas were significantly improved in the VA and TVA groups in comparison to the control group (p ＜ 0.01), but there was no significant difference between the VA and TVA groups.
  
  
  CONCLUSIONS
  The short-term venous drainage from the flap end after surgery was as effective as long-term VA. Flap transplantation could therefore be clinically easier and more reliable when starting short-term venous drainage during surgery.
authors.affiliation: Department of Plastic and Reconstructive Surgery and Maxillofacial Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume city, Fukuoka prefecture 830-0011, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Fukushima
authors.forename: Yojiro
authors.initials: Y
authors.lastname: Inoue
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kiyokawa
authors.forename: Hideaki
authors.initials: H
authors.lastname: Rikimaru
authors.forename: Koichi
authors.initials: K
authors.lastname: Watanabe
mesh_terms: D000005:Abdomen / Q000098:blood supply / Q000601:surgery; D000818:Animals; D006085:Graft Survival; D008297:Male; D008866:Microsurgery; D051381:Rats; D017208:Rats, Wistar; D019651:Plastic Surgery Procedures / Q000379:methods*; D018709:Statistics, Nonparametric; D013524:Surgical Flaps / Q000098:blood supply*; D014680:Veins / Q000601:surgery*