Effects of venous superdrainage and arterial supercharging on arteialized venous flap in a rat model

Abstract

Introduction. Despite that various experimental patterns of venous flaps have been proposed, no single pattern have gained widespread acceptance. Aim of the study. To evaluate the effects and survival rate of venous superdrainage and arterial supercharging on arterialized venous flaps (AVFs) in rat models. Materials and methods. Experimental study. In a group of 24 white rats was used the arterialized venous epigastric flap according to the model of E.Vaubel and J.Hußmann. Vascular ends were isolated over 1.5 cm proximally. For arterialization of the venous bed of the epigastric flap, an end-to-end anastomosis was performed between the proximal end of femoral artery and the distal end of femoral vein. Venous outflow was performed along the branches of the venous anastomoses of the superficial epigastric vein and the lateral thoracic vein. The lot was divided in 4 groups (n=6): I - venous flap non-arterialized, II - arterialized venous flap (AVf) with arterial supercharging, III - AVf with adequate arterial perfusion, IV - AVf with venous super drainage. Clinical state was assessed by flaps color, capillary response, edema. Results. 7 days postoperatively, venous flaps without arterial perfusion and venous flaps with arterial supercharging have necrotized in 100%, flaps with a ratio of leading and discharging vessels 1:1 were grafted in 16,6% with partial necrosis. Non-free venous arterialized flaps with venous superdrainage (1:2 ratio) survived in 100% of cases, with partial necrosis in 50%. Conclusions. The most optimal connection option for survival of the arterialized flap is the pattern described for group IV– with venous super drainage (ratio of 1: 2 or more), with acceptable survival and failure rate.