Reconstruction of Soft Tissue Defects of Multiple Digits with Arterialized Venous Free Flap

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Journal of the Korean Society for Surgery of the Hand 2004;9(1):12-20.
Published online January 1, 2004.

Gi-Jun Lee, Kyung-Chul Kim, Sun-O Yu, Jong-Dai Bek, Joo-Sung Kim, Sang-Hyun Woo

유리 동맥화 정맥 피판술을 이용한 다발성 수지의 연부 조직 결손의 재건

이기준, 김경철, 유선오, 백종대, 김주성, 우상현

Abstract

This study investigated the clinical application of arterialized venous free flaps as a single-staged procedure in the coverage of soft tissue defects in multiple digits. There were thirteen patients with either multiple digit amputations or multiple digit soft tissue defects. Five patients had twodigit involvements and eight patients had three digit involvements that required simultaneous skin coverage. The ipsilateral volar forearm was the preferred donor site. Flap size averaged 28.6 cm2 (12~70 cm2). Mean number of afferent and efferent vessel anastomosis was 1.31 and 1.92, respectively. In two cases, innervated arterialized venous flaps were raised to reconstruct the digital nerve. Mobilization was initiated one week after surgery. Release of surgical syndactyly was carried at an average of 34 days after surgery. Complete flap survival was obtained in 85% of the cases. Partial necrosis (10% and 40%) occurred in two cases. No secondary flap procedure was necessary. The single-staged arterialized venous flap proves to be a versatile and reliable option in providing thin, pliable skin coverage for multiple digital soft tissue defects.

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