Venous Flaps for Revascularization and Soft-Tissue Coverage in Traumatic Hand Injuries: A Systematic Review of the...

Area of Science:

• Microsurgery
• Reconstructive Surgery
• Hand Surgery

Background:

• Venous flaps have been used for over 30 years for revascularization and soft tissue defect coverage.
• First described in 1981, venous flaps can be transposed with graft survival.
• This study systematically reviews venous flap survival in traumatic hand injuries.

Purpose of the Study:

• To determine predictors of venous flap survival in traumatic hand injuries.
• To evaluate the efficacy of venous flaps in hand reconstruction.

Main Methods:

• Systematic literature search of PubMed, MEDLINE, and Cochrane Library.
• Keywords included vein graft, revascularization, venous flap, and traumatic hand injuries.
• Analysis of 626 free venous flaps from 43 articles.

Main Results:

• Overall venous flap survival rate was nearly 95% (79.6% healed completely, 14.7% partial loss, 5.8% total loss).
• Most patients were males with right-hand injuries.
• Forearm was the common donor site; medium skin paddles (10-25 cm²) and arterial inflow were frequently used.

Conclusions:

• Venous flaps provide good results with limited morbidity for hand injuries.
• Younger patients, arterial inflow, and medium-sized skin paddles predict successful venous flap survival.
• Venous flaps are a viable option for simultaneous revascularization and soft tissue coverage in the hand.