An alternative solution of donor site venous problems in free flap reconstruction of skin defects in the volar region of the finger: Transposition of dorsal skin veins.

Objecitive: The volar surface of the fingers has unique functional and cosmetic properties. When conventional methods are insufficient to reconstruct the volar defects of fingers, the only effective method is free flaps. Fingers have proper arteries, but veins are the most problematic for free flap surgery. Volar veins are relatively small in caliber, and this makes the most reason for flap loss. The aim of this study is to examine 15 cases applied with vein transposition during the reconstruction with the free flap of traumatic finger defects.

Material And Method: This research was conducted between 2016 to 2021; we analyzed the dorsal vein transposition technique as a solution for volar vein problems which we face during the fingers defect reconstruction with free flaps. Flap arteries were anastomosed end to side, and veins end to end with vein, which transposed from the dorsum of the fingers.

Results: There are 9 venous and 6 superficial branch of radial artery free flap surgery was performed to reconstruct volar surface defects of fingers. The patients comprised 20% females and 80% males with a mean age of 42.3±7 years. The patient's mean flap size was 9.99±2cm. The success rate was determined to be 93.34%.

Conclusion: In the repair of finger defects with a free flap, the use of vein transposition should be kept in mind as an alternative and rescue option.