Ry. Yuan et al., CIRCULATING MECHANISM OF THE PURE VENOUS FLAP - DIRECT OBSERVATION OFMICROCIRCULATION, Journal of reconstructive microsurgery, 14(3), 1998, pp. 147-152
The circulating mechanism of the ''pure'' venous flap was studied via
venography and direct observation of the microcirculation through tran
sparent ear chambers and ear edges in a rabbit model. The flap, withou
t arterial inflow, survived with normal hair growth and wound healing.
Renewed blood circulation occurred 3 to 5 hr after transfer. There we
re two typical flow patterns in the venules: one was a shaking movemen
t with high frequency and short range; the other was a pendulum-like m
ovement with low frequency and long range. The former was related to h
eart rate, while the later was not. The pendulum-like movement was the
main flow responsible for perfusion of capillaries. Blood flow in the
capillaries occurred 1 to 2 hr later than that in the venules. The pe
ndulum-like flow perfused the capillaries in two ways: one was in the
direction of venules to capillaries and then back to venules along the
same route; the other was from venules to arterioles through arteriov
enous shunts and then to capillaries. The first type of perfusion was
gradually replaced by the second 2 days after transfer. There were ext
ensive venous plexus flows in the flap, which lasted more than 4 weeks
after transfer. Revascularized vessels ultimately supplied blood to t
he flap. The dynamic energy for the movement of blood at an early post
-transfer stage was probably due to spontaneous venomotion.