Fingertip reconstruction by palmar bipedicular island flap in long fingers (modified neurovascular Tranquilli–Leali flap): A dual-center study

Outcomes of bipedicle V-Y ‘cup’ flap for repair of volar oblique fingertip amputations

“…The use of skin grafting versus secondary healing (for closure of the donor site defect of bipedicle flaps) is controversial. The donor site can be left to heal secondarily and there is no need for skin grafting (Elliot et al., 1995; Kapandji et al., 1991; Loréa et al., 2006; Sérane-Fresnel et al., 2020). Some do not favour skin grafting because it was observed that a skin graft acts as a permanent and suboptimal skin cover, whereas secondary healing may result in a painless scar (Loréa et al., 2006; Sérane-Fresnel et al., 2020).…”

“…The donor site can be left to heal secondarily and there is no need for skin grafting (Elliot et al., 1995; Kapandji et al., 1991; Loréa et al., 2006; Sérane-Fresnel et al., 2020). Some do not favour skin grafting because it was observed that a skin graft acts as a permanent and suboptimal skin cover, whereas secondary healing may result in a painless scar (Loréa et al., 2006; Sérane-Fresnel et al., 2020). Skin grafting is also associated with morbidity of the secondary donor site.…”

“…Skin grafting is also associated with morbidity of the secondary donor site. The mean time off work was relatively long in series with secondary healing (Loréa et al., 2006; Sérane-Fresnel et al., 2020). One study used skin grafting to avoid this problem, and allow an earlier return to work (Schuind et al., 1985).…”

“…Therefore, it has been suggested that the dorsal branch of the neurovascular bundles should be preserved at these levels (Kojima et al., 1994; Macht and Watson, 1980; Shaw, 1971). More recently, the level of the proximal base of bipedicle flaps has gradually become more distal, and no case of dorsal ischaemia has been reported when the base of the flap is distal to the PIPJ (Chi et al., 2020; Elliot et al., 1995; Furlow, 1984; Kapandji et al., 1991; Loréa et al., 2006; Schuind et al., 1985; Sérane-Fresnel et al., 2020). Moreover, the dorsal branches were not always protected (Elliot et al., 1995; Furlow, 1984; Loréa et al., 2006).…”

Reconstruction of Multiple Digital Defects by Temporary Syndactylization Using a Lateral Arm Free Flap

“…Sensory recovery at fingertips is important after reconstructive surgery and this favors the use of reverse digital artery island flaps, homodigital neurovascular island flaps, step advancement island flaps, or toe pulp free flaps. 1 11 12 13 14 Ideally, multiple toe pulp flap reconstruction should be used in patients with multiple fingertip defects. However, the single patient with such defects would have needed three toe pulp free flaps, which would have been challenging even for an experienced microsurgeon.…”