Reconstruction of Large Dorsal Digital Defects With Arterialized Venous Flaps

Abstract

Coverage of the dorsal aspect of the fingers is difficult, especially when the defect is large and multiple digits are involved with composite tissue loss and very few conventional flaps are suitable in dealing with such situation. The purpose of this study was to present our experience of reconstruction of the large dorsal digital defects with the arterialized venous flap (AVF) and evaluate its merits and demerits in this clinical setting with a comprehensive review of literature. From August 2008 to December 2010, 7 composite palmaris longus venous flaps and 5 AVFs were used in the reconstruction of extensive dorsal digital injuries in 8 patients, and a comprehensive review of literature regarding the reconstruction of dorsal digital defects with AVFs was carried out. All the flaps survived completely. The outcomes were very satisfactory for functional recovery, aesthetic appearance, and sensation restoration at an average follow-up of 11.8 months; the literature review also revealed the similar results. On the basis of our experience and literature review, AVFs are reliable and good candidates for resurfacing large dorsal digital defects when local flaps are not available or insufficient for coverage. Composite AVF with palmaris longus tendon is an optimal choice for 1-stage reconstruction of dorsal composite finger injuries.

The reverse dorsal metacarpal artery flap in finger reconstruction: A reliable choice

“…Arterialised venous flaps are also used for large dorsal finger defect associated with dorsal hand defects especially when the local options are not available. [ 10 ] The RDMA flap is a well-described entity for the finger defect reconstruction. It was first described in literature by Maruyama and Quaba in 1990.…”

Arterialized Venous Bone Flaps: An Experimental Investigation

“…Although the exact mechanism of successful tissue perfusion in AVFs is unclear, various clinical and experimental studies have confirmed skin flap survival using this unconventional technique4571016171819. AVFs may be harvested in a wide range of locations.…”

Arterialized Venous Flaps in Reconstructive and Plastic Surgery

“…[10] Recently, we performed 7 composite palmaris longus venous flaps and 5 arterialized venous flaps with an average size of 6.1cm x 2.9 cm in the reconstruction of post-traumatic extensive dorsal digital injuries in 8 patients. [48] All the flaps survived completely despite of the occurrence of universal venous congestion and swelling. The outcomes at an average followup of about 12 months were very satisfactory in terms of functional recovery, aesthetic appearance and sensation restoration.…”