FURTHER CLINICAL USE OF THE INTERPOSITION ARTERIOVENOUS LOOP GRAFT INFREE TISSUE TRANSFERS

The use of an arteriovenous fistula (AVF) to afford vascular access fo r free tissue transfer is described in 11 consecutive patients from a 1 year period. The leg was the site of pathology in six cases, and a r eversed saphenous AVF to the femoral vessels was created. In the remai ning five cases, those in the head and neck and arm regions, the recip ient vessels varied. The mean patient age was 37.7 years, and ten of 1 1 patients were male. Etiologies of defect were automobile accidents i n six cases, neoplasm in three, and gun-shot wound and electrical inju ry in one patient each. Mean ischemia time was 113 +/- 15 min. Mean le ngth of AVF was 27.3 +/- 2.1 cm. All flaps survived. AVF was a useful technique in the current study. Several maneuvers were undertaken to m inimize the risk of thrombosis. All patients were given aspirin prior to AVF creation. Patients received dextran 40 in the postanastomosis p eriod for 5 days. Finally, every effort was made to create the AVF bet ween large vessels, especially in the leg, to maximize blood flow. (C) 1993 Wiley-Liss, Inc.