PMC6103316_01
Total hand skin degloving injury.. Notes: (A) Before surgery. (B) Superficial forearm vein with four branches. (C) "Y shape" superficial forearm vein graft.
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In addition, skin avulsion on the fingers started from the superficial layer of flexor digital tendon sheath and extensor tendon (Figure 2A). Debridement and vessel-transplanting replantation were conducted in the patient under brachial plexus block, and six-hand veins were anastomosed intraoperatively (Figure 2B). Specifically, the superficial vein of forearm was transplanted, and the ruptured second to fifth arteria digitalis communis was anastomosed with ulnar artery, while the first to second arteria digitalis communis was anastomosed with radial artery (Figure 2C).
Appearance and function after surgery.. Notes: (A) Palm side at 2 years after surgery. (B) Dorsal side at 2 years after surgery. (C-F) Finger flexion function at 2 years after surgery.
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The patient paid a subsequent visit 2 years postoperatively, and favorable texture of palmar and dorsal hand skin could be observed (Figure 3A and B). Moreover, favorable finger appearance could be attained, thumb abduction and digital opposition function had been restored, and satisfactory recovery of finger flexion and extension function had been achieved (Figure 3C-F).