Direct and reversed dorsal digital island flaps: A review of 65 cases

Chen, Chao; Tang, Peifu; Zhao, Gang

doi:10.1016/j.injury.2014.08.030

Cited by 9 publications

(7 citation statements)

References 16 publications

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“…Partial distal flap necrosis was noted in five cases (15%), which represented 10-20% of the originally used flaps in their study. (10) In general, in the reverse-flow blood supply flap, the blood comes from the contralateral digital artery, so that caused a higher rate of blood flow insufficiency, which may adversely affect the survival of the flap. (9) One of the advantages of digital artery perforator flap used in our study is that it is a sensate flap and does not require nerve anastomosis to the recipient area since it contains 2-3 dorsal branches of the proper digital nerve.…”

Section: Resultsmentioning

confidence: 99%

Repair of Fingertip Defect Using an Anterograde Pedicle Flap Based on the Dorsal Perforator

Dr¹,

Naji

2019

IqNJM

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Background. The hand is the most frequently injured body part. Injuries to the fingertips are among the most common hand injuries. In this article an anterograde pedicle flap based on the dorsal branches of proper digital artery from the dorsum of the middle phalanx was used to reconstruct the fingertip defect as described by Peng Wei MD in a single stage to provide a durable, sensate coverage with the least possible complications. Aim of study. To introduce and assess the result and long term follow up of using an anterograde pedicle flap based on the dorsal branches of proper digital artery from the dorsum of middle phalanx. Patients and method. A total of twelve male patients were presented to us between November 2016 and January 2018. All of them had history of fingertip injuries and had undergone reconstruction using anterograde pedicle flap based on the dorsal branches of proper digital artery from the dorsum of the middle phalanx” the period of follow up ranged from one month to six months with an average of three months. Result. In this study 12 patients presented with fingertip defect were surgically treated by using an anterograde pedicle flap based on the dorsal perforator. All the patient had satisfactory result with good pliable contour coverage of their injured fingertip with no restriction of finger movements. Conclusion. The use of anterograde island flap based on the dorsal branches of proper digital artery from the dorsum of middle phalanx is suitable for reconstruction of fingertip defects of various amputation planes, it provided good contour texture with preservation of digital artery and nerve, it also provides patient with acceptable fingertip appearance.One of the major drawbacks of this procedure is that it requires tedious and meticulous dissection and that donor site requires full-thickness skin graft, which leads to donor site morbidity and scarring. Keywords.

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Section: Resultsmentioning

confidence: 99%

Repair of Fingertip Defect Using an Anterograde Pedicle Flap Based on the Dorsal Perforator

Dr¹,

Naji

2019

IqNJM

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“…Therefore, our study only provided a profile of patient preferences rather than the full picture. Moreover, there are still many available flaps of choice that we did not include in this study, such as an adipofascial digital artery perforator flap, dorsal digital island flaps, or an abdominal flap [ 19 , 20 ]. Thus, the selected attributes should be adjusted to different applications or national healthcare policies.…”

Section: Discussionmentioning

confidence: 99%

Incorporating Patient Preferences into a Decision-Making Model of Hand Trauma Reconstruction

Chang

Wang

Hsieh

et al. 2021

IJERPH

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Background: Few studies have addressed patient preferences in emergent surgical decision making. Aim of the study: Analyzing patient preferences for hand trauma reconstruction to propose a decision-making model. Methods: A conjoint analysis survey was developed with Sawtooth Software. Three common flaps—i.e., a cross-finger flap (CFF), a dorsal metacarpal artery perforator flap (DMAPF), and an arterialized venous flap (AVF)—were listed as treatment alternatives. Five attributes corresponding to these flaps were recovery time, total procedure, postoperative care methods, postoperative scar condition, and complication rate. Utility and importance scores were generated from the software, and preference characteristics were evaluated using cluster analysis. Results: The survey was completed by 197 participants with hand trauma. Complication risk received the highest importance score (42.87%), followed by scar condition (21.55%). Cluster analysis classified the participants as “conservative,” “practical,” and “dual-concern.”. The dual-concern and conservative groups had more foreign laborers and highly educated participants, respectively, than the other groups. Most participants in the conservative and practical groups preferred DMAPF, whereas those in the dual-concern group favored CFF. Our proposed model consisted of shared decision-making and treatment recommendation pathways. Conclusion: Incorporating patient preferences into the decision-making model can strengthen patient-centered care. Further research on the applications of the proposed model is warranted.

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“…The dorsum of the proximal phalanx is innervated by the dorsal digital nerve (DDN), which originates from the superficial branch of the radial nerve and the dorsal branch of the ulnar nerve. 12 , 13 The dorsal digital perforator flap innervated by DDNs can be used for innervated reconstruction of the fingertip.…”

Section: Methodsmentioning

confidence: 99%

Innervated Reconstruction of Fingertip Degloving Injury Using a Dorsal Digital Perforator Flap Combined With a Cross-Finger Flap

Wang

et al. 2022

Ann Plast Surg

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BackgroundThe reconstruction of a fingertip degloving injury presents a functional and aesthetic challenge. We used a dorsal digital perforator flap combined with a cross-finger flap to reconstruct this type of injury. The purposes of this retrospective study were to evaluate the efficacy of the combined flaps and to present our clinical experience.MethodsFrom November 2016 to October 2019, 16 patients (13 men and 3 women) with fingertip degloving injuries were treated with a dorsal digital perforator flap combined with a cross-finger flap for innervated reconstruction. We used an innervated dorsal digital perforator flap for the reconstruction of the dorsal defect of the degloved fingertip and an innervated cross-finger flap for the volar defect. The average size of the defect was 4.2 × 1.9 cm. The average sizes of the flaps were 2.3 × 2.1 cm (the dorsal digital perforator flap) and 2.5 × 2.1 cm (the cross-finger flap).ResultsAll flaps and skin grafts survived completely without ischemia or venous congestion. All wounds and their donor sites healed primarily without exudation and infection. Patients were followed up for a mean time of 11.3 ± 1.9 months (range, 9–15 months). At the final follow-up, no significant difference was seen in the averaged total active motion between the injured fingers and the contralateral fingers. No significant difference was found in the averaged total active motion between the donor fingers and the contralateral fingers. All flaps obtained excellent or good sensory performance. All flaps had mild cold intolerance. Thirteen patients had no pain, 2 reported mild pain, and 1 experienced moderate pain. Ten patients were very satisfied with the appearance of the reconstructed finger.ConclusionsThe dorsal digital perforator flap combined with a cross-finger flap is an effective and reliable method for the reconstruction of fingertip degloving injuries.

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Direct and reversed dorsal digital island flaps: A review of 65 cases

Cited by 9 publications

References 16 publications

Repair of Fingertip Defect Using an Anterograde Pedicle Flap Based on the Dorsal Perforator

Repair of Fingertip Defect Using an Anterograde Pedicle Flap Based on the Dorsal Perforator

Incorporating Patient Preferences into a Decision-Making Model of Hand Trauma Reconstruction

Innervated Reconstruction of Fingertip Degloving Injury Using a Dorsal Digital Perforator Flap Combined With a Cross-Finger Flap

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