Francisco del Piñal, MD, PhD, Francisco J. García-Bernal, MD, PhD, Leopoldo Cagigal, MD, Alexis Studer, MD, Higinio Ayala, MD, Javier Regalado, MD

J Hand Surg 2009;34A:453–457. © 2009 Published by Elsevier Inc. on behalf of the American Society for Surgery of the Hand

Abstract: The progressive evolution and late salvage of a posttraumatic digit with poor vascularization has not been discussed in the literature. We report the cases of 3 patients whose fingers were rescued at referral 5 to 16 days after the traumatic event by restoring the arterial inflow by means of flow-through free flaps. All 3 fingers were compromised vascularly with patchy necrosis and absence of Doppler signal distal to the injury. All were salvaged. In our experience, in the setting of a posttraumatic digit with poor vascularization, it is possible to reverse impending necrosis by late revascularization. Frank infection or mummification is considered an irreversible state and a contraindication to salvage.