The venocutaneous fistula: a new technique for reducing venous congestion in replanted fingertips.

The venocutaneous fistula technique, which involves the construction of a temporary venous return bypass using a venous graft, was devised to prevent venous congestion after fingertip replantation surgery. The proximal side of the venous graft is anastomosed to a vein at the dorsum of the finger. The distal side of the graft is sutured to the skin around a punch wound on the volar side of the replanted fingertip. This procedure was applied successfully to four fingertips in two patients without any anastomosis of the proper vein or the application of bleeding wound techniques or medicinal leeches. This method provides an excellent alternative in the treatment of venous congestion.