End-of-Skin Grafts in Syndactyly Release: Description of a New Flap for Web Space Resurfacing and Primary Closure of Finger Defects

Sharma, Ramesh Kumar; Tuli, Puneet; Makkar, Surinder; Parashar, Atul

doi:10.1007/s11552-008-9134-y

Cited by 32 publications

(34 citation statements)

References 16 publications

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“…The reported series was composed of 7 patients with 14 web releases and a maximum of 3.5 years of follow-up. 23 A dorsal pentagonal island flap reconstruction showed no cases of contracture or web creep after an average follow-up of 34 months. 22 Ekerot described a trilobed flap technique and observed no incidence of web creep or flexion contracture.…”

Section: Discussionmentioning

confidence: 88%

Long-Term Outcomes of Web Creep, Scar Quality, and Function After Simple Syndactyly Surgical Treatment

Lumenta

Kitzinger

Beck

et al. 2010

The Journal of Hand Surgery

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Section: Discussionmentioning

confidence: 88%

Long-Term Outcomes of Web Creep, Scar Quality, and Function After Simple Syndactyly Surgical Treatment

Lumenta

Kitzinger

Beck

et al. 2010

The Journal of Hand Surgery

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“…However, the flap is prone to insufficient venous backflow. 11 We use multiple techniques to minimize the occurrence of venous congestion following the flap transfer. First, a skin bridge is attached to the flap pedicle, and the flap is transferred through an open tunnel without any distortion and compression of the pedicle.…”

Section: Discussionmentioning

confidence: 99%

Distally Based Dorsal Digital Fasciocutaneous Flap for the Repair of Digital Terminal Amputation Defects

Hou¹,

Ju²,

Zhao³

et al. 2013

International Surgery

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The preferred plastic surgery regimen for distal digital segment wounds remains unknown, although multiple options are available for the repair. The purpose of this investigation is to study its anatomic rationale and clinical outcomes, in addition to the role of dorsal digital veins in digital reconstruction. Patients (n = 765) suffering from digital terminal segment traumatic wounds (823 digits) were identified and reviewed in a retrospective manner. The wounds were repaired using distally based dorsal digital fasciocutaneous flaps with venoneuroadipofascial pedicles. Skin flaps survived in 818 digits (99.4%), whereas 5 flaps (0.6%) became partially necrotic. Postoperative follow-up data were available from 521 patients involving 559 digits, for an average duration of 10 months (range, 4-36 months). The wider pedicled fascial flap (1.0-1.5 cm) was significantly associated with a decreased occurrence of blebs, whereas the first few patients with pedicled fascial flaps 0.5 to 1.0 cm wide exhibited more frequent occurrence of blebs and flap contractures. The flaps retracted in size within the first 2 to 3 months at the rate of 10% compared with the intraoperative outlined size. The skin flaps became mildly pigmented within the first postoperative month, and at 6 months the flaps turned brighter in color, almost approximating the color of the normal digits. At 12 months, both the texture and appearance of the flaps were acceptable. The donor sites healed without any scar contracture. The digital terminals appeared grossly normal with acceptable digital function. Without any neural reconstruction, skin flap sensation was rated as S2 to S3+, whereas with neural reconstruction the 2-point discrimination sensitivity measured 4 to 9 mm. The use of a distally based dorsal digital fasciocutaneous flap with venoneuroadipofascial pedicle was a simple, safe, and less invasive regimen for repairing digital terminal segment wounds.

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“…Most of them are either random or axial pattern based on the metacarpal artery. Various designs of flaps in V-Y advancement [6,27,28], hourglass shape [9,29], trilobed [3,30], pentagonal [5], reverse island [7,8], distally based dorsal hand flap [31] were described for web-space reconstructions. Thus, digital incisions-whether zigzag or straight-could be closed primarily.…”

Section: Discussionmentioning

confidence: 99%

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

2009

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Skin grafts and local flaps are conventional methods for repairing simple syndactyly. Skin grafts usually leave unsightly appearance and contracture formation. In this study, unipedicled distally based venous flap were raised from third or fourth metacarpal area of the hand for syndactyly treatment. The distally based venous flap was to provide skin coverage to one side of the finger, in order to avoid complications arising from using skin graft. Nine patients' syndactylies (5 simple incomplete and 4 simple complete syndactyly) were treated using this method. The mean follow-up period of the flaps was 14 months, ranging from 12 to 16 months. Mild edema and venous congestion occurred in all flaps. Superficial necrosis involving two flaps did not affect flap survival. All flaps survived completely. In this article, we have described a new surgical technique for the correction of syndactyly in a single surgical procedure that utilizes a distally based venous flap to provide skin coverage without skin graft.

show abstract

End-of-Skin Grafts in Syndactyly Release: Description of a New Flap for Web Space Resurfacing and Primary Closure of Finger Defects

Cited by 32 publications

References 16 publications

Long-Term Outcomes of Web Creep, Scar Quality, and Function After Simple Syndactyly Surgical Treatment

Long-Term Outcomes of Web Creep, Scar Quality, and Function After Simple Syndactyly Surgical Treatment

Distally Based Dorsal Digital Fasciocutaneous Flap for the Repair of Digital Terminal Amputation Defects

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

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