Journal of Plastic, Reconstructive and Aesthetic Surgery Venous system mapping of the digits and the hand: an anatomical study and potential surgical applications

BACKGROUND: Venous anatomy of the digits and the hand is poorly reported in the literature compared to the 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 is 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 coloured 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 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.