Great toe-to-hand transfer nourished by arterial inflow through the venous system.

Abstract

Revascularization of tissues through their venous system is currently used in vascularized venous flaps and in replantation of some fingertips. A toe-to-hand transfer that suffered prolonged and unexplainable arterial spasm, unrelenting to the usual therapeutic measures, was revascularized through its venous system. Tissue perfusion in the toe began 24 hours after the vascular repairs were through, because arterial flow was hampered by the venous valves in the toe. Tissue perfusion was poor initially but became stable 72 hours postoperatively, and the toe survived. The only complications were epidermolysis and pseudoarthrosis. We consider this technique for tissue revascularization as a suitable salvage method in cases where all other therapeutic measures fail.