Vein graft in toe to hand transfers

These authors describe indications, techniques, short- and long-term results of toe to hand transfers using the vein grafts. 145 toe to hand transfers were performed in 115 patients. Fifty cases necessitated 44 vein grafts in 37 patients; there were 41 vein to artery and 3 vein to vein grafts carried out. The grafts were used to bridge defects of a vessel over 55 mm (usually in patients with heavy posttraumatic scar formation and/or distrophic changes resulting from burns and frost-bite in the vessel stumps, or in the main vessel nourishing the transplant), both in primary surgery and in re-operation following the resection of the thrombosed microanastomosis. Success was achieved in 28 patients who underwent primary interposition of vein grafts, with 34 survivals (90%) of 38 transferred toes. That exceeded the average survival rate of 84%. In 9 patients vein grafting of arteries followed the resection of the thrombosed microanastomoses and resulted in 5 survivals of 12 transferred toes. In 6 cases vein grafts to arteries were performed both intraoperatively and in re-operation. In this group of patients 7 of 8 transferred toes survived for re-operation had been prompt. Venous grafting in toe to hand transfers carried out without delay and in full conformity with the indications, produced results statistically similar to those obtained in procedures involving no venous grafting.