Arterialized venous flaps in hand reconstruction: a review and analysis of own experience

Objective. To analyze literature and our data on free arterialized venous flaps for repair of hand skin defects; to identify problems following arterialization of venous bed of skin flaps. Material and methods. Between January 2018 and December 2024, the authors used 19 arterialized venous flaps to repair hand skin defects in 18 patients (12 men and 6 women). Mean age was 42 years. All patients were healthy without chronic diseases. Results. Mean flap area was 12 cm². One flap included the palmaris longus tendon to repair extensor pollicis longus tendon defect. Eleven (58%) out of 19 flaps healed without necrosis. Partial necrosis developed in 4 (21%) flaps. Thus, full-thickness skin grafting was necessary in 2 patients, finger stump was created in one patient. Another patient, the wound healed via secondary intention. Total flap necrosis occurred in 4 (21%) patients. Of these, 2 patients received finger stumps. One patient underwent SCIP flap grafting. In one case, the wound healed via secondary intention. Conclusion. Arterialized venous flaps are a good alternative to classic arterial flaps for repairing hand skin defects. However, these flaps require appropriate microsurgical experience and deep understanding of circulation.