Document Detail

The deep venous system and reverse flow flaps.
MedLine Citation:
PMID:  8298777     Owner:  NLM     Status:  MEDLINE    
The deep venous system of the upper and lower extremities was injected with a lead oxide mixture in 2 fresh human cadavers, dissected, radiographed and the sites of the venous valves located. These studies confirmed that the macrovenous connections between the venae comitantes of the distributing arteries were insufficient in number to bypass the venous valves in conventional, distally based reverse flow flaps (e.g. radial, ulnar, peroneal) but revealed an alternative microvenous interconnecting pathway which surrounds the artery as the venae arteriosa. This pathway was investigated in a series of distally based reverse flow saphenous flaps in dogs, comparing flaps where the microvenous connections were left intact (non-skeletonised) with those where these vessels were disconnected with the operating microscope (skeletonised). All non-skeletonised flaps survived subtotally or totally whereas total necrosis was observed in 70% of the skeletonised flaps. Finally a series of haemodynamic studies was performed to test valve competency including extrinsic pressure on the valves. It is concluded that the macrovenous and microvenous pathways, coupled with the variable anatomy of the venous valves, are major factors in determining the survival of reverse flow flaps.
F del Pinal; G I Taylor
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  British journal of plastic surgery     Volume:  46     ISSN:  0007-1226     ISO Abbreviation:  Br J Plast Surg     Publication Date:  1993 Dec 
Date Detail:
Created Date:  1994-03-08     Completed Date:  1994-03-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  2984714R     Medline TA:  Br J Plast Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  652-64     Citation Subset:  IM    
Department of Anatomy, University of Melbourne, Australia.
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MeSH Terms
Arm / blood supply*
Arteries / anatomy & histology
Cell Survival / physiology
Graft Survival
Hemodynamics / physiology
Hindlimb / blood supply
Leg / blood supply*
Regional Blood Flow / physiology
Saphenous Vein / physiology
Surgical Flaps / physiology*
Veins / anatomy & histology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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