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Arch Hand Microsurg > Volume 19(1); 2014 > Article
Journal of the Korean Society for Surgery of the Hand 2014;19(1):29-35.
Published online March 30, 2014.
DOI: https://doi.org/10.12790/jkssh.2014.19.1.29   
Efficiency of Vein Repair for Distally Based Avulsion Flap Injury of the Hand and Forearm
Dong Ho Kang, Jae Hyun Kim, Hyun Jae Nam, Ho Jun Cheon, Young Woo Kim, Sang Hyun Woo
Cheon & Woo's Institute for Hand and Reconstructive Microsurgery, W Hospital, Daegu, Korea. handwoo@hotmail.com
Received: 19 February 2020   • Revised: 21 January 2014   • Accepted: 22 January 2014
Abstract
Purpose
The purpose was to evaluate the efficiency of vein repair on flap survival in distally based avulsion flap injury of the hand and forearm.

Methods
Sixteen cases of distally based avulsion flap injury larger than 30 cm2 in size of the hand and forearm in which vein repair was done were enrolled. All had a avulsion injury by rolling machine. To survive the flap, extensive debridement was done to reduce the size of distally based flap injury as little as possible. Thereafter, an average of 1.4 vein were repaired. Postoperatively, hyberbaric oxygen therapy was performed for 2 weeks. The flap survival was assessed at three weeks after operation.

Results
When comparing the size of distally based avulsion flap injury and flaps that survived after operation, excellent results were observed in 12 cases, and good results in 4 cases. Additional operation was required including split thickness skin graft in 4 cases. A reverse island fasciocutaneous flap was performed in one case, and elbow joint arthrolysis was performed in another one.

Conclusion
Treatment of distally based avulsion flap injury of the hand and forearm using vein repair lead to relatively satisfying results in flap survival by allowing earlier motion of the joint, providing favorable functional results.
 
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