Reconstruction of the Soft Tissue Defect of the Finger Using Digital Island Flap with Supercharged Vein.

Choi, Hwan Jun; Kim, Nam Joong; Choi, Chang Yong

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2009;36(2):153-160.
Published online March 1, 2009.

Reconstruction of the Soft Tissue Defect of the Finger Using Digital Island Flap with Supercharged Vein.

Hwan Jun Choi, Nam Joong Kim, Chang Yong Choi

Department of Plastic and Reconstructive Surgery College of Medicine, Soonchunhyang University, Seoul, Korea. medi619@hanmail.net

Abstract

PURPOSE
The heterodigital or homodigital artery island flap is a popular method in reconstruction of finger defects. Sometimes, digital artery island flap has some disadvantages such as postoperative flap edema, congestion, and partial necrosis of the flap margin. However, we could decrease these disadvantages by means of venous superdrainage. The aim of this study is to report usefulness and postoperative results of venous supercharging digital artery island flaps for finger reconstruction. METHODS: From March 2005 to March 2008, a total of eight patients with soft tissue defects in the finger underwent venous supercharging digital island flap transfer. Briefly, the flap is harvested along with dorsal vein that is then anastomosed to the recipient vein in an end-to-end fashion, after flap transfer and insetting. Using this technique, eight patients were operated, whose ages ranged from 23 to 52 years.
RESULTS
All the flaps survived with a success rate of 100 percent, thus fully satisfying the reconstructive requirements. No postoperative flap congestion was recognized, obviating the need to take any measures for venous engorgement, such as suture removal. Among 8 cases, it was possible to make an long-term and follow- up observation more than 6 months. In these cases, the fact that light touches and temperature sensations can be detected in all the flaps. Cold intolerance and hyperesthesia were not seen in our series.
CONCLUSION
Providing good harmony with conventional methods and microsurgery, inclusion of a vein with the heterodigital and homodigital artery island flap allows a more reliable and safer reconstructive choice for finger defects. The venous supercharged island flap is a reliable flap with a consistent arterial structure, and with its augmented venous drainage, it is more reliable, providing single-stage reconstruction of adjacent finger defects, including the fingertip.

Keywords: Venous supercharging; Fingertip injury; Digital artery

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