Venous flaps for covering skin defects of the hand.

Thirty cases of skin defects of the hand were treated with 32 venous flaps. Seven of the flaps used were flow-through venous flaps (V-V type), in which venous blood flows in and out. Of the arterialized venous flaps into which arterial blood flows, the outflow in nine cases was anastomosed to a vein (A-V type), that in 15 cases to an artery (A-A type), and one flap had inflow only. Twenty-one of the flaps were completely successful, but seven resulted in partial and four in complete necrosis. Indications for V-V flaps are skin defects of small dorsal areas of the fingers, but this type of flap can also be used for skin defects in the dorsal area of the hand, if the number of veins anastomosed is increased. The A-V flap is especially indicated for covering multiple digital skin defects, while the best indication for A-A flaps is a skin defect on the lateral or volar side of the digit which requires simultaneous reconstruction of blood circulation.