Arterialized Venous Free Flap for Hand Defect Reconstruction Due to Ischemic Steal Syndrome

Rani Septrina,1 Putie Hapsari,2 Irra Rubianti Widarda,1 Ronny Lesmana,3 Reno Rudiman,4 Rizky Abdulah,5 Amelia Febrina6 1Division of Plastic Reconstructive Surgery, Department of Surgery, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, West Java, Indonesia; 2Division of Vascular Surgery, Department of Surgery, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, West Java, Indonesia; 3Department of Physiology, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia; 4Division of Digestive Surgery, Department of Surgery, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, West Java, Indonesia; 5Department of Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, West Java, Indonesia; 6Trainee in Plastic Reconstructive and Esthetic Surgery Training Program, Universitas Padjadjaran, Bandung, West Java, IndonesiaCorrespondence: Rani Septrina, Department of Surgery, Universitas Padjadjaran/Hasan Sadikin General Hospital, Jl. Prof Eyckman No. 38, Bandung, West Java, 40161, Indonesia, Email [email protected]: Ischemic steal syndrome (ISS) occurs in hemodialysis patients. Hence, it rarely becomes gangrene or disrupts hand function. We reported a patient with an ISS and radial atherosclerosis that presented with infected ulcer. The patient was treated with arterialized venous free flap from the contralateral forearm. Dialysis access can be used as early as 10 days after the flap. The report also describes the long-term functional follow-up after reconstruction. Although there was superficial flap necrosis, this non-physiologic flap can preserve the patient’s hand function.Keywords: Ischemic steal syndrome, hemodialysis access, arterialized venous free flap, hand function