SALVAGE OF SUPERFICIAL PALMAR AVULSION

Avulsion injuries of the hand caused by moving rollers usually create a distally or, less commonly, a laterally based skin flap. Progressive necrosis in the distant part of the flap usually occurs because of ar terial insufficiency and venous stasis over the next 2 to 3 weeks. Fro m 1991 to 1994, we applied the concept of the ''arterialized venous fl ap'' to salvage the palmar tissue by revascularizing the superficial p almar venous network with an arterial anastomosis in eight patients. S ix of the flaps survived completely and two had a small strip of margi nal necrosis which healed secondarily. When compared with conventional methods, this method can remarkably improve the circulation of the fl ap and provide a better cosmetic and functional result for the highly specialized palmar tissue.