Arterialized venous flap (AVF) has become the most commonly used technique among the four venous flap techniques. AVF harvested from the volar forearm is suitable for digital defect reconstruction, as the color, texture, pliability, and thinness are similar. Moreover, AVF can be performed using a simple technique, provide various flap designs for the defects, and be attached to additional tissues such as cutaneous nerves and tendons. Thus, AVF is often used as an alternative to conventional flaps for digital defects. In our hospital, 14 AVFs were used for digital reconstruction. All the flaps survived even though partial congestion was initially detected in 10 AVFs (71.4%) . Recently, shunt restriction and retrograde anastomosis have been performed to reduce congestion; however, we did not perform these techniques in the present study. Further studies are needed to elucidate the reasons why the AVFs survived without congestion-reduction techniques. Our findings and a review of the literature suggest that AVF for digital reconstructions is safe in cases where countermeasures to reduce congestion were not performed.
