title: Arterialized venous flow-through flaps in the reconstruction of digital defects: case series and review of the literature.
abstract: BACKGROUND
  Arterialized venous flow-through (AVFT) flaps are useful in reconstructing small soft tissue defects. Currently, no guidelines exist for the use of AVFT flaps for reconstructing soft tissue defects in the digits of the hand. We retrospectively reviewed our experience with AVFT flaps and developed a selection process for vascular anastomoses.
  
  
  METHODS
  We reviewed the use of AVFT flaps in a series of ten consecutive patients requiring reconstruction of small soft tissue defects of the fingers.
  
  
  RESULTS
  Between 2006 and 2012, ten consecutive digital reconstructions were performed using AVFT flaps. Flap sizes ranged from 5 to 13.5 cm(2). Initial congestion was seen in all flaps and resolved within 3-7 days. Leeches were utilized in two cases. All cases achieved good functional results. Three illustrative cases from our series of ten are presented, each demonstrating key decision-making factors in selecting recipient and flap vessels for anastomosis.
  
  
  CONCLUSIONS
  AVFT flaps appear congested post-operatively, resolving in days to weeks, and resulting in healthy coverage of digital soft tissue defects with good functionality. We suggest a selection process for the use of AVFT flaps in digital soft tissue reconstruction, based on dorsal vs. volar and proximal vs. distal defect location, and the flap's inherent venous architecture.
authors.affiliation: Division of Plastic Surgery, University of Utah Health Sciences Center, 30 North 1900 East, 3B400, Salt Lake City, UT 84132 USA.
authors.forename: Jared W
authors.initials: JW
authors.lastname: Garlick
authors.affiliation: Division of Plastic Surgery, University of Utah Health Sciences Center, 30 North 1900 East, 3B400, Salt Lake City, UT 84132 USA.
authors.forename: Isak A
authors.initials: IA
authors.lastname: Goodwin
authors.affiliation: Department of Surgery, Plastic Surgery Section, University of Arkansas for Medical Sciences, 4301 W. Markham St. #720, Little Rock, AR 72205 USA.
authors.forename: Keith
authors.initials: K
authors.lastname: Wolter
authors.affiliation: Division of Plastic Surgery, University of Utah Health Sciences Center, 30 North 1900 East, 3B400, Salt Lake City, UT 84132 USA.
authors.forename: Jayant P
authors.initials: JP
authors.lastname: Agarwal
keywords: Arterialized venous flow-through flaps; Hand & digital reconstruction; Hand & digital soft tissue defects; Venous flaps