Venous Flaps

Venous flaps are rarely used in reconstructive surgery. Their physiology is still relatively unknown. They are classified based on the number and function of veins.
Venous Flaps

Venous Flaps

5 Key Points

1. The exact physiology of venous flaps is relatively unknown
2. Thatte and Thatte is the standard classification for venous flaps
3. 3 types of venous flaps based on the number of veins & their function
4. They do not have a high survival rate and are not used regularly
5. An example is a saphenous vein flap.

Venous Flap Physiology  

The exact mechanism of venous flaps is currently not completely understood. There are different theories and contributing factors that relate to:

  • Perfusion pressures: reverse shunting and reverse flow
  • Arteriovenous anastomosis
  • Plasmatic imbibition
  • Vascular connections

An example of a venous flap is the saphenous vein flap. 

Classification of Venous Flaps

Thatte and Thatte classify venous flaps into 3 categories based on the number of veins and their function. They are generally quite thin flaps as they contain skin and fat only, not the fascia.

  • Type 1: unipedicled venous flap
  • Type 2: bipedicled venous flow-through flap
  • Type 3: arterialisation of a venous flap through a proximal AV anastomosis and a distal vein.

Thatte and Thatte Venous Flap Classification 

Pitfalls of Venous Flaps

Venous flaps are not routine reconstruction surgical practice due to their poor survival rates and general lack of understanding of their physiology.

There are some small advantages to this type of flap

  • Reliable anatomy (for example saphenous vein)
  • Minimal donor site morbidity.

A common complication of a venous flap is venous congestion. 


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