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Arch Hand Microsurg > Volume 24(2); 2015 > Article
Archives of Hand and Microsurgery 2015;24(2):75-78.
Published online November 30, 2015.
DOI: https://doi.org/10.15596/ARMS.2015.24.2.75   
Reconstruction of High-Pressure Paint Gun Injection Injured Finger Using Free Flaps with T-Shaped Pedicles and Multiple Venous Anastomoses
Jun Beom Lee, Hwan Jun Choi<sup><xref ref-type="corresp" rid="cor1">*</xref></sup>, Jun Hyuk Kim, Nam Ju Cheon, and Young Man Lee
Department of Plastic and Reconstructive Surgery, Soonchunhyang University College of Medicine, Cheonan, Korea. medi619@hanmail.net
Received: 21 September 2015   • Revised: 11 November 2015   • Accepted: 17 November 2015
Abstract

High-pressure (HP) injection injury to the upper extremity often causes a very serious clinical problem, leading to poor outcomes, including amputation, so that a true surgical emergency is required. The outcomes can be improved with emergent wide surgical debridement. However the diagnosis of these injuries is often delayed due to underestimated evaluation at first appearance and lack of common knowledge of the seriousness of this injury. The type and pressure of the infecting material is an important factor in prognosis and organic solvents infected pressure injury can cause poor outcome and increased amputation rate. In this case, we report on reconstruction of HP oil-based paint injection injuries of the finger using T-shaped pedicles and multiple venous anastomoses. In this concept, arterial flow can be maintained by the reverse flow of distal anastomosis when there is difficulty with the proximal anastomosis. And venous flow can be preserved by deep and superficial vein anastomosis. This concept has various advantages including preserving patency of the pedicle in chronic vasculopathy or trauma cases and maintaining the arterial flow by the reverse flow of distal anastomosis and can improve the free flap survival by a two vascular anastomosis system.

Key Words: High pressure, Paint, Anastomosis, Free flap
 
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