[Primary repair of soft tissue defect in fingers with arterialized venous flap]

Ruihua Li, Shilian Kan, Mingxin Li
Chinese Journal of Reparative and Reconstructive Surgery 2008, 22 (7): 797-9

OBJECTIVE: To summarize the results of the free transplantation of anti-valve-inflow and pro-valve-outflow arterialized venous flap in repairing soft tissue defect of fingers in emergency treatment.

METHODS: From October 2002 to March 2007, 7 cases of soft tissue defects of fingers were repaired with arterialized venous flaps. There were 6 males and 1 female, aged 17-46 years. Defect was caused by crush injury in 6 cases and by stab injury in 1 case. The interval between injury and operation was 2-7 hours and the size of defects ranged from 3.0 cm x 2.0 cm to 6.0 cm x 3.5 cm. All defects were repaired by arterialized free venous flap from the ipsilateral forearm, in which the proximal ends of veins were anastomosed to artery and vein of the finger. The donor site was directly sutured.

RESULTS: Six cases of arterialized venous flap survived completely and 1 case had partial superficial necrosis and healed with conservative management. The donor site healed by first intention. Postoperative follow-up ranged from 3 months to 4 years, the texture and the thickness of the flaps were satisfactory, only one presented partial pigment deposits because of superficial necrosis. No sclerosis, contracture and limited range of motion occurred in all flaps. According to the evaluation criteria for upper limb function issued by Hand Surgery Branch of Chinese Medical Association, the results were excellent in 3 cases and good in 4 cases.

CONCLUSION: It is an ideal method to repair soft tissue defect of fingers by using anti-valve-inflow and pro-valve-outflow arterialized venous flap.

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