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The authors used a delayed arteriovenous (A-V) shunt method to prevent congestion and necrosis of arterialized venous flaps. Two weeks before elevating the flap, an A-V shunt between the central artery and vein was created at the more proximal flap end. Twelve rabbits (24 flaps) were used for this experiment. Flaps were followed for 4 weeks. Twelve of 24 flaps survived completely; another 10 flaps showed partial necrosis; and two flaps became completely necrotic. These results demonstrated that this method is superior to a simple A-V shunt in preventing congestion and necrosis in the arterialized venous flap.
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