Literature Selection| Near-Infrared Vein Visualization in Index Finger Pollicization

NEAR INFRARED VEIN VISUALIZATION devices allow for noninvasive identification of veins for multiple uses. They function by illuminating the skin with near-infrared light (700e900 nm), which penetrates the skin and subcutaneous tissues to a depth of approximately 3 mm (Lingyu and Leedham, presented at the IEEE International Conference on Video and Signal Based Surveillance, 2006). The light is differentially absorbed by the underlying tissues, with increased absorption by deoxygenated hemo-globin. The difference in absorption is detected by the device camera, and a reproduction of this is projected onto the subject’s skin in real time. The technique is commonly used in pediatric hospitals for improving the ability to obtain intravenous access and may aid in obtaining venous access in difficult situations. It has also been used to identify potential donors for vein grafts, minimizing the incision size at the harvest site, and to aid in the planning and design of free fiaps for breast reconstruction.

During index finger pollicization, the dorsal veins must be preserved to allow blood out?ow from the digit. The goal is to separate the veins from both the skin and the extensor mechanism while not disturbing their associated fat envelope. Knowledge of the location and number of these veins prior to skin incision provides con?dence during dissection of the dorsal tissues.

Near-infrared vein visualization is useful to identify the pattern and location of dorsal veins on the index finger during pollicization procedures. Identification of vein locations prior to surgical incision allows for gentle treatment of the veins, providing the best chance for preservation of blood out?ow from the digit.

Near-infrared vein visualization is a noninvasive tool, with no known harmful effects. It is not dependable for identifying deep arteries and veins, such as the digital artery. 

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