Efficiency of Vein Repair for Distally Based Avulsion Flap Injury of the Hand and Forearm

Purpose: The purpose was to evaluate the efficiency of vein repair on flap survival in distally based avulsion flap injury of the hand and forearm.Methods: Sixteen cases of distally based avulsion flap injury larger than 30 cm 2 in size of the hand and forearm in which vein repair was done were enrolled.All had a avulsion injury by rolling machine.To survive the flap, extensive debridement was done to reduce the size of distally based flap injury as little as possible.Thereafter, an average of 1.4 vein were repaired.Postoperatively, hyberbaric oxygen therapy was performed for 2 weeks.The flap survival was assessed at three weeks after operation.Results: When comparing the size of distally based avulsion flap injury and flaps that survived after operation, excellent results were observed in 12 cases, and good results in 4 cases.Additional operation was required including split thickness skin graft in 4 cases.A reverse island fasciocutaneous flap was performed in one case, and elbow joint arthrolysis was performed in another one.Conclusion: Treatment of distally based avulsion flap injury of the hand and forearm using vein repair lead to relatively satisfying results in flap survival by allowing earlier motion of the joint, providing favorable functional results.