Arch Hand Microsurg.  2021 Sep;26(3):193-198. 10.12790/ahm.21.0087.

Cephalic Vein Supercharging to Prevent Venous Congestion for a Reverse Radial Forearm Flap Used in the Reconstruction of Dorsum of Hand: A Case Report

• Kim JL
• Chun JY
• Lee NH
• Shin JY
• Roh SG

• KMID: 2519473
• DOI: http://doi.org/10.12790/ahm.21.0087

Abstract

The reverse radial forearm flap is often co-opted for soft tissue reconstruction of the dorsum of hand. Venous congestion can lead to flap necrosis or failure. To improve dorsum hand reconstruction outcomes, sufficient venous drainage is very important. In this case report, we discuss the situation of a 66-year-old male patient with a serious degloving injury on the dorsum of his right hand. After reverse radial forearm flap adaptation, venous anastomosis between the cephalic vein and the dorsal superficial vein was performed prophylactically and the patient recovered well without congestion or complications. We implemented venous supercharging, which is a relatively easy and simple procedure, to prevent venous congestion. The success of the procedure shows that venous supercharging can aid in the prevention of venous congestion.

Keyword

Hand injuries; Radial forearm flap; Congestion; Venous supercharging

Figure

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  Fig. 1. A 66-year-old male presented with a traumatic soft tissue defect on the dorsum of his right hand with exposed underlying structures.

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  Fig. 2. After serial debridement, the remaining defect measured about 9×10 cm on the dorsum of the right hand.

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  Fig. 3. Design of the flap.

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  Fig. 4. Elevation of the flap.

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  Fig. 5. (A, B) Venous supercharging between the cephalic vein and the dorsal superficial vein.

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  Fig. 6. (A, B) The flap was rotated to the dorsal defect and the donor site was covered with a skin graft.

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  Fig. 7. At 6 months postoperatively, the patients recovered well without specific complications.

Reference

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