[Autologous vein transplants for digital revascularization after hand injuries]

In this study, reverse autogenous vein grafts were employed to bypass vascular defects in replantations and occluded arteries in hands with chronic post-traumatic ischemia. In 32 thumb replantations, vein grafts were used as short interposition segments or longer bypass grafts. The bypass grafts have the advantage of permitting proximal and distal anastomoses in undamaged tissue. In 5 post-traumatic chronically ischemic hands, vein grafts were employed to bypass arterial occlusions. All grafts remained open and cold intolerance improved as tactile discrimination returned. Simultaneous arterial and nerve reconstruction with grafts achieved favorable results in 2 patients. The measurement of digital blood pressure with the aid of a Doppler ultrasonic probe permitted preoperative evaluation of the degree of ischemia and postoperative confirmation of patency of the vein grafts.