Arterialized Venous Skin Flaps for the Injured Finger

Abstract

Seven cases of arterialized venous skin flaps for the treatment of both skin defects in the fingers, and digital arterial defects, are presented. The method involves taking the skin flaps along with a subcutaneous vein from the flexor side of the distal forearm or the dorsal aspect of the foot, and interpositioning the vein in the flap between the missing digital artery, to cover the skin defect as well as to restore blood circulation. The size of the flaps ranged from 1.0 x 1.0 cm to 4.5 x 3.0 cm. Almost complete survival of flaps was achieved in all cases. This method does not sacrifice any portion of the digital artery, and is also an excellent technique for restoring blood circulation and reconstructing skin defects simultaneously.

Artery–Vein–Artery Venous Flap for Simultaneous Soft-Tissue Repair and Radial Artery Reconstruction: Case Report

“…They concluded that, in cases of small skin defects such as those seen in the fingers, both donor sites are effective. 8 Our case demonstrates that the dorsum of the foot might serve as a reliable donor site for larger defects, as well. We recommend Doppler evaluation to ensure adequacy of flow when designing a venous flap.…”

“…7 The largest of the previously reported AVA flaps was 3.0 ϫ 4.5 cm. 4,5,7,8 Our case illustrates that a similar approach to simultaneous reconstruction can be accomplished on a larger scale at the wrist using an AVA flap.…”

A-A Type, Arterialized, Venous, Flow-Through, Free Flap for Simultaneous Digital Revascularization and Soft Tissue Reconstruction???Revisited

“…6 Nishi's results were similar: 5 complete survival, 1 partial necrosis, and 1 superficial necrosis. 7 The patients in our study had functional digits with a good range of movement and protective sensation, thus justifying the salvage of these digits rather than performing amputation.…”

“…They described 5 other cases in which the flap was used to reconstruct a gap in the digital artery and provide soft tissue cover, but in which revascularization was not mandatory. 7 In our experience of A-A arterialized venous flowthrough flaps, both flaps survived. Inoue et al reported 5 of 7 cases with complete survival, 1 partial necrosis and 1 complete necrosis.…”

Composite Palmaris Longus-Venous Flap for Simultaneous Reconstruction of Extensor Tendon and Dorsal Surface Defects of the Hand???Long-Term Functional Result

“…Local tissues are often the preferred choice for soft tissue replacement; however, limited availability frequently makes free flap reconstructions, such as the venous flap, necessary. [1][2][3][4][5] Non-vascularized tendon grafts, even if used in the primary reconstruction, also have limited functional outcome as they are prone to adhesions. The composite arterialized venous flap with palmaris longus tendon was first introduced by Inoue for a one-stage reconstruction of combined tendon and soft tissue defect in the hand.…”