American Society of Hirudotherapy

Anastomosis to the common and proper digital vessels in free flap soft tissue reconstruction of the hand

Retrospective review published in Microsurgery (2016)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Research reportClinical TrialsDiaz-Abele J et al. · Microsurgery, 2016

Abstract

OBJECTIVE: This study seeks to demonstrate the safety of anastomosing free flaps to the common or proper digital artery, and to the volar or dorsal digital vein in soft tissue reconstruction of the hand; as well, as to discuss the advantages of this technique. METHODS: Retrospective review of all patients who underwent free flap reconstruction of the hand in two institutions over a period of 5 years. RESULTS: A total of 29 free flaps (9 great toe pulp, 7 anterolateral thigh, 6 second toe pulp, 4 radial artery perforator, 2 partial medial rectus, 1 lateral arm) in 28 patients met our inclusion criteria. All recipient vessels were the proper or common digital artery and the volar or dorsal digital vein. There was one case of venous congestion that resolved with leeching. There was no partial or total loss of any of the flaps. CONCLUSION: Anastomosing soft tissue free flaps to the common or proper digital artery, and the volar or dorsal digital vein is a safe and effective approach with numerous advantages that should be considered in the reconstruction of soft tissue defects of the hand. © 2016 Wiley Periodicals, Inc. Microsurgery, 38:21-25, 2018.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal Article
Indexed MeSH termsAnastomosis, SurgicalArteriesFingersFree Tissue FlapsHand InjuriesHumansPlastic Surgery ProceduresRetrospective StudiesTreatment OutcomeVeins

Summary

Retrospective review of 29 free flaps for soft-tissue hand reconstruction using digital-vessel anastomosis. One venous-congestion case resolved with leech therapy; no flap losses.

Why This Matters for Hirudotherapy

This retrospective review of 29 free flaps in 28 patients for hand soft tissue reconstruction demonstrated that anastomosing flaps to common or proper digital arteries and volar or dorsal digital veins is safe, with no partial or total flap loss. One case of venous congestion resolved with leeching. This is relevant to ASH's domain as it documents leech therapy successfully used to treat venous congestion in a digital free flap, supporting the role of medicinal leeches as a salvage modality in reconstructive surgery. The honest caveat is that leeching was a minor single-instance event within a larger surgical series, no details about leeching protocol or species are provided, and the abstract's focus is on surgical anastomosis safety rather than leech therapy outcomes.

Citation

Anastomosis to the common and proper digital vessels in free flap soft tissue reconstruction of the hand.

Diaz-Abele J et al. · Microsurgery, 2016

DOI

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.