Congenital syndactyly: Defatting facilitates closure without skin graft

The Use of an Hourglass Dorsal Advancement Flap Without Skin Graft for Congenital Syndactyly

“…Defatting of the fingers and the interdigital space was performed to facilitate closure without skin graft, which may reduce recurrence and web creep. 7,9,10,16,18 Although defatting may lead to a thin finger, we observed no conspicuous change in finger contour compared with the non-syndactylized fingers in our cases. This may be because of the early separation age and good tissue regeneration capacity in children.…”

Distally based venous flap: a new technique for the correction of syndactyly without skin graft in adult patients

“…Surgeons prefer operative techniques that allow closing incisions primarily. For this aim, extensive defatting of the fingers has been performed and found that defatting helped primary closure independent from flap configuration [4]. Authors experienced digital nerve laceration during fat removal and scar contracture.…”

“…Use of split thickness or full thickness grafts are advocated; however, both have some drawbacks such as flexion and extension lags, more web-creep formation, hyperpigmentation, hair growth and wound breakdown [2]. Some surgical techniques are inclined to close incisions primarily [3][4][5]. However, this may lead to tension on wound edges and cause dehiscence and secondary healing.…”

Hourglass Dorsal Metacarpal Island Flap: A New Design for Syndactylized Web Reconstruction

“…Extensive defatting of the fingers and the interdigital space has been performed to facilitate closure without skin graft. 15 However, aggres- sive defatting carries the risk of vascular injury and may lead to a thin finger after involution of fat of infancy. 12 The transfer of external flaps from the dorsum of the hand, whether a random or axial pattern, has been a major component of efforts made toward a skin graftfree reconstruction.…”