Abstract:

Objective　To investigate the causes of the venous drainage problem of different pedicled flaps adopted for resurfacing of the defects in the hand as well as the methods to improve the condition. Methods　56 patients various kinds of hand skin defects were treated with flaps pedicled on the nutrient vessels of the distal thumb dorsal cutaneous nerve,the retrograde dorsal metacarpal flaps and flaps based on the nutirent vessels of the dorsal branch of the hand according to the type of the defect.    Results    Falps in all cases survived. 3 cases treated with flaps pedicled on the nutrient vessels of the distal thumb dorsal cutaneous nerve suffer marginal necrosis in early stage, which was cured by dressings change.  Conclusions    The treatment of the pedicle is the key to the surival of different pedicled flaps. Superficial vein ligation of pedicle flaps can effectively reduce the incidence of venous crisis after flap transplantation.

Key words: Hand skin defect, Distal pedicle flaps, Venous return