Application of free vein flap of foot in replantation of amputated finger with soft tissue defect

LIU Wei

doi:10.3969/j.issn.1009-4237.2018.02.018

Abstract：Objective To investigate the clinical effect of free flap of foot vein in replantation of amputated finger combined with soft tissue defect.Methods From 2014-2017,28 patients were treated with free flap of foot vein for replantation of amputated finger combined with soft tissue defect in our hospital.Among them 21 were males and 7 were females with an average age of 37.0(17-55)years.There were 3 cases of amputation in thumb,12 ca-ses in index finger,5 in middle finger,4 in ring finger and 4 in little finger.Most of the fingers were completely amputated without any soft tissue connection associated with injuries of blood vessel and nerve.The amputated fin-gers were reserved.The venous flap shape was designed as 10%bigger than the defect area,and the axis of the flap were consistent with the trend of vein.The skin flap was cut along the designed size,and the free flap of deep fascia layer of flap was carried out.After the flap was free,the proximal and distal vein was cut back and transplanted into the finger.The natural artery and the dorsal digital vein were bridged.If the distal skin gradually referred to the body well,and blood supply of the skin edge was good,namely vascular anastomosis with good blood supply,direct suture could be applied.If suture was not feasible, skin graft was achieved from the inside of the arm or in the groin.After the operation,the drainage skin flap was placed under the flap.Results All 28 cases of amputated finger and finger vein flap were survived,and the shape was good and the motor function was satisfactory.Conclu-sion The application of free vein flap of foot in replantation of amputated finger with soft tissue defect is simple and convenient, with high survival rate and little damage to donor site .