Veno-accompanying artery fasciocutaneous flap

Our group developed the veno-accompanying artery fasciocutaneous (VAF) flap, which was a new concept of flap developed in the 1990s that depended on unnoticed blood supply. The VAF flap is a high versatility pedicle flap which can be created almost anywhere with cutaneous veins. However, distally based VAF flaps are prone to congestion in the peripheral part of the flap compared to proximally based flaps, and thus are unsuitable for large defects. The VAF flap cannot be used in infected sites or compression sites, because the blood supply of VAF flaps comes from arterioles accompanying the cutaneous veins. Therefore, we created a new concept of flap-the VAF-myocutaneous (mc) combined flap- to compensate for this drawback. The VAF-mc flap includes a portion of muscle to increase the blood supply to the flap. In this article, we describe the history of the discovery of the VAF flap and its recent modifications.