2-STAGE ARTERIALIZED FLOW-THROUGH VENOUS FLAP TRANSFER FOR 3RD-DEGREEBURN DEFECTS ON THE DORSUM OF THE HAND

A modified, two-stage arteriovenous flow-through venous flap was desig ned to repair skin defects due to third-degree burns on the dorsum of the hand in four patients. Two weeks after plasty of an arteriovenous (A-V) shunt between the greater saphenous vein and dorsalis pedis arte ry, the arterialized flow-through venous flap was transferred using th e greater saphenous vein as the pedicle. The size of the flaps utilize d ranged from 7 x 13 cm to 9 x 13 cm. In three patients the entire fla p survived without complication. In one patient whose flap had only on e drainage vein, the flap survived with superficial necrosis of about 10 percent of the flap at the borders. During the 2 weeks after A-V sh unt creation, the authors believe that microcirculation around the art erialized vein probably develops, contributing to better irrigation an d thereby to flap survival. Using this two-stage procedure, it might b e feasible to obtain larger grafts and to attain a higher flap surviva l rate.