Treatment of Multiple Finger Laceration Caused by Green Onion Cutting Machines in South Korea.

Background: Finger injuries caused by green onion cutting machines in Korean kitchens have unique characteristics of an incomplete amputation in which multiple parallel soft tissues and blood vessels are injured in the same form. In this study, we aimed to describe unique finger injuries and to report the treatment outcomes and experiences of performing possible soft tissue reconstructions. Methods: This case series study included 65 patients (82 fingers) from December 2011 to December 2015. The mean age was 50.5 years. We retrospectively classified the presence of fractures and the degree of damage in patients. The injured area involvement level was categorised as distal, middle or proximal. The direction was categorised as sagittal, coronal, oblique or transverse. The treatment results were compared according to the amputation direction and injury area. Results: Of the 65 patients, 35 had a partial finger necrosis and needed additional surgeries. Finger reconstructions were performed through stump revision or local or free flap use. The survival rate was significantly lower in patients with fractures. As for the injury area, distal involvement led to 17 out of 57 patients displaying necrosis and all 5 patients showing the same in proximal involvement. Conclusions: Unique finger injuries caused by green onion cutting machines can easily be treated with simple sutures. Then prognosis is affected by the extent of injury and the presence of fractures. Reconstruction is necessary for finger necrosis owing to extensive blood vessel damage and limitations when making this selection. Level of Evidence: Level IV (Therapeutic).

Finger soft tissue reconstruction using arterialized venous free flaps having 2 parallel veins.

PURPOSE: Arterialized venous free flaps with a single straight venous axis may require redirection of either the efferent or afferent vein for anastomosis to the digital vessels. To simplify these flaps, the authors propose use of an arterialized venous free flap having 2 parallel veins that does not require redirection of the veins. METHODS: The authors performed 44 arterialized venous free flaps having 2 parallel veins for the reconstruction of digital soft tissue defects. The mean area of coverage was 6.5 cm(2). The donor sites included the volar aspect of the distal forearm in 35 cases, the thenar area in 8 cases, and the dorsal aspect of the foot in 1 case. RESULTS: Thirty-nine of the 44 flaps survived. Complete flap necrosis occurred in 5 cases, and flap congestion was seen in 28 cases. CONCLUSIONS: The authors had satisfactory results using arterialized venous free flaps having 2 parallel veins. By using these flaps, the authors were able to simplify the technique of arterialized venous flaps. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.