Medial Plantar Venous Flap: Classic Donor Site Modification for Hand Defects. Issue 4 (October 2018)

• Record Type: Journal Article
• Authors: Wang, Yanmao; Wu, Tianyi; Lu, Shengdi; Zhong, Wanrun; Hu, Chengfang; Wen, Gen; Chai, Yimin
• Is Part Of: Annals of plastic surgery. Volume 81:Issue 4(2018)
• Publication Date: 2018-10
• Subjects: medial plantar flap -- venous flap -- soft tissue defects -- flow-through; Surgery, Plastic -- Periodicals; 617.95205
• DOI: 10.1097/SAP.0000000000001487
• Languages: English
• ISSNs: 0148-7043

Abstract

Abstract : Background: Destruction of digits from trauma results in a much more significant influence on patients' mental state and quality of life than do injuries to other parts. The purpose of this study was to describe a novel modification of medial plantar venous flap for soft tissue defects in the hands and digits. Methods: Nine patients received medial plantar venous flap to resurface soft tissue defects in the hands or digits between January 2015 and February 2017. This flap can be used either in a free-island pattern or in a flow-through pattern through the medial branch of the great saphenous vein. All patient data including preoperative statues and follow-up examinations (flap survival rates, complication rates, total active motion, static 2-point discrimination, and Semme-Weinstein test score) were analyzed. Results: We included 6 men and 3 women, with a mean age of 34.2 years. The medial plantar venous flaps were used for vascularization in 5 patients because of segmental defects of bilateral digit arteries. Eight flaps survived uneventfully in this study. One flap partially failed (20% of the flap area) because of venous congestion. The functional outcomes and sensory restoration were satisfied for all 9 flaps. Conclusions: Compared with the traditional medial plantar flap, the medial plantar venous flap involves a simpler surgical procedure and allows for revascularization of distal areas using the flow-through technique. Furthermore, the medial plantar area presents a sensitive, glabrous skin with proper bulkiness and allows for movement of the underlying structure.