Conclusion:
Thumb replantation is a difficult surgical technique that necessitates high precision and skills. Anastomosis of small diameter superficial veins can be difficult, and vasodilation may be required to allow the venous coupler to fit into it. The use of papaverine is safe and efficient to achieve sufficient vasodilation and allow for successful anastomosis. Nonetheless, as with any medication, the patient’s existing co-morbidities should be carefully evaluated before using papaverine. The effective application of papaverine in this example and the significant increment in the vein diameter demonstrates its potential value in microsurgery, particularly when vessels are small relative to that of the coupler.