Objective. Experimental study of pathological anatomy and physiology of venous system in transplantation of non-free and free fasciocutaneous flaps.

Material and methods. There were 5 series of experimental studies on animals (125 white rats, 25 animals per a series). We have analyzed the peculiarities of venous outflow in non-free (in different variants of preparing of the vascular pedicle) and free fasciocutaneous flaps.

Results. We found a high sensitivity of venous system of epigastric flap to any surgical manipulation starting from dissection of the flap (without dissection of vascular pedicle). Surgical effect on vascular pedicle of epigastric flap (various options for axial vessel denervation) and even more vascular pedicle intersection with subsequent restoration of blood flow in the free flap were accompanied by enlargement and tortuosity of the main tributaries forming a valveless axial vein, venous congestion, tissue edema and sludge complexes of erythrocytes in venules and veins.

Conclusion. Considering these and earlier data on the features of arterial perfusion of free flaps, we performed a computer animation of arterial inflow and venous outflow in epigastric flaps after reperfusion using mathematical modeling of biomechanics of cardiovascular system. In general, own results and modern literature data suggest a paradigm shift in the choice of design of venous anastomoses.

Keywords. microsurgical flaps, venous anastomotic thrombosis, fasciocutaneous flap, erythrocyte sludge complexes, computer modeling and animation of blood flow