Feasibility of type III venous flap in coverage of hand defects following trauma and burns.

INTRODUCTION: venous flaps are alternative reconstructive option for coverage of defects. They are nourished by venous blood flow or by arterial blood flowing through the venous network. This study was conducted to assess the feasibility of venous flap in coverage of extremities defects following trauma and burns.

MATERIAL AND METHODS: Over a period of one year, 15 arterialized venous flaps were applied to skin defects of the hand. Postoperatively flap were monitored for survival and patients followed up for three months.

RESULTS: In patients with flap area ranging from 6 to 10 cm(2), all the 6 patients have complete survival (100%). In 11-15 cm(2) group 3 out of 5 patients have complete survival (60%) and 2 have partial survival (40%). In 16-20 cm(2) group 1 out of 3 have complete survival (33.3%) and 2 have partial survival (66.6%). In 21-25 cm(2) group there was only 1 patient who had complete necrosis. This study suggests that small venous flaps have better survival rate as compared to large flaps. Variable degree of congestion was present in all the patients in first post operative week which gradually disappeared in second week.

CONCLUSION: The venous flap is good alternate for reconstruction of the small defects of hand and digits. It is easy to designed and harvest. It is thin and pliable, without need to sacrifice a major artery at the donor site and with no limitation on the donor site.