Venous system mapping of the digits and the hand: An anatomical study and potential surgical applications
Martin Lhuaire,
Guillaume Wavreille,
Mikael Hivelin,
Aurélien Aumar,
Vincent Hunsinger,
Mohamed Derder,
Alexandre G. Lellouch,
Peter Abrahams,
Laurent Lantieri,
Christian Fontaine
Affiliations
Martin Lhuaire
Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Université de Paris, Paris, France; Institute of Anatomy and Organogenesis, Faculté de Médecine Henri Warembourg, Université de Lille, Lille, France; SOS Hands and Fingers, Clinique Lille Sud, Lesquin, France; Correspondence to: Dr Martin LHUAIRE, Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, 20 rue Leblanc, 75908, Paris Cedex 15, France. Tel: +33 1 56 09 58 71.
Guillaume Wavreille
SOS Hands and Fingers, Clinique Lille Sud, Lesquin, France
Mikael Hivelin
Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Ambroise Paré, Assistance Publique des Hôpitaux de Paris, Université Paris-Saclay, Paris, France
Aurélien Aumar
SOS Hands and Fingers, Clinique Lille Sud, Lesquin, France
Vincent Hunsinger
Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Université de Paris, Paris, France
Mohamed Derder
Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Université de Paris, Paris, France
Alexandre G. Lellouch
Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Université de Paris, Paris, France; Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Peter Abrahams
Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom
Laurent Lantieri
Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Université de Paris, Paris, France
Christian Fontaine
Institute of Anatomy and Organogenesis, Faculté de Médecine Henri Warembourg, Université de Lille, Lille, France
ABSTRACT: Background: Venous anatomy of the digits and the hand is poorly reported in the literature compared to arterial anatomy. While knowledge of the venous anatomy is crucial to ensure safe skin incisions, skin flap design, or blood return restoration for digital replantations, data in anatomical and clinical textbooks are rather limited. The purpose of this anatomical study was to describe the venous anatomy of the digits and the hand. Method: Our series reports descriptive results from 10 non-embalmed hand dissections from 5 different corpses. Hands were previously co-injected by arteries followed by veins with a different colored latex before being dissected under optical magnification (x4). Each anatomical specimen was photographed before being analyzed. Results: Each injection revealed both arterial and venous vascular systems. Latex injections were a useful technique to show the dorsal, volar superficial, and deep venous system. There was a constant and reliable topographic vascular anatomy of the superficial venous system of the digits and hand. However, we could not observe a high density of dorsal superficial venous valves as previously reported. Conclusion: The knowledge of the arrangement of the venous system of the digits and the hand should help the surgeon when performing surgical procedures in the hand. The surgeon should take into consideration this venous anatomy when performing skin incisions, skin flaps, or replantation procedures which would preserve the normal venous physiology as much as possible.
