Venous supercharging of heterodigital artery flap.
BACKGROUND
The heterodigital artery island flap is a popular method of reconstruction for finger defects. Postoperative venous congestion is a common problem.


METHODS
The authors present a technique to augment venous drainage of the flap. Briefly, the flap is harvested along with a dorsal vein that is then anastomosed to a recipient vein in an end-to-end fashion, after flap transfer and insetting. Using this technique, seven patients were operated on, ranging in age from 5 to 35 years (average age, 23 years).


RESULTS
All flaps survived with no postoperative flap congestion, fully satisfying the reconstructive requirements. By this modification, skeletonization of the digital artery of the flap pedicle is safe if that approach is preferred, since there is no need to harvest periarterial fat for venous drainage.


CONCLUSIONS
Providing good harmony with conventional methods and microsurgery, inclusion of a vein with the heterodigital artery island flap allows a more reliable and safer reconstructive choice for finger defects. Such a modification converts the unconventional venous circulation of the heterodigital artery island flap to a more physiologic one.
Akyurek
Mustafa
M
Worcester, Mass.; and Antalya, Turkey From the Division of Plastic Surgery, University of Massachusetts Medical Center, and the Department of Plastic and Reconstructive Surgery, Akdeniz University.
Ozkan
Omer
O
Babbitt
Russell
R
Dunn
Raymond M
RM
D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D002648:Child; D002675:Child, Preschool; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps / Q000098:blood supply*; D014656:Vascular Surgical Procedures / Q000379:methods*; D014680:Veins / Q000601:surgery; D014689:Venous Insufficiency / Q000517:prevention & control*