Modified first dorsal metacarpal artery island flap for sensory reconstruction of thumb pulp defects

Wang, H.; Chen, C.; Li, J.; Yang, Xiaoxi; Zhang, H.; Wang, Z.

doi:10.1177/1753193415610529

Cited by 30 publications

(20 citation statements)

References 30 publications

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“…The main disadvantages of these flaps are the inferior sensory recovery and the scar over the nearby visible donor area. The use of neurotization in FDMA[ 7 ] and cross finger flap[ 8 ] improves the sensory recovery, but the donor scar and colour texture match are still poor. Digital artery perforator flap is another option which gives tissue match with donor site scar which is still poor.…”

Section: Discussionmentioning

confidence: 99%

Free toe pulp flap for finger pulp and volar defect reconstruction

Balan¹

2016

Indian J Plast Surg

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Background:Fingertip injury requiring flap cover is very common in the modern era. The ideal cover should fulfill both functional and aesthetic improvement.Materials and Methods:From June 2015 to April 2016, we performed seven free toe pulp flaps for finger defect reconstruction. All patients were males. Five flaps were done in emergency post-traumatic cases, and two were done in elective set up. The cases included reconstruction of three thumbs, one index and one ring finger in an emergency set up and two ring fingers in the elective. Thumb reconstruction was done with great toe lateral pulp and the other digits reconstructed with second toe pulp flap. Follow-up evaluation included both functional and aesthetic assessment.Results:Five flaps survived completely, one suffered partial loss, and one flap failed completely. The median follow-up period was 9 months. The median duration of surgery was 255 min (range 210 to 300 min). The median two-point discrimination was 6.5 mm (range 4–8 mm). There was the return of temperature sensation in all patients; two had cold intolerance. The Semmes-Weinstein monofilament score varied from 3.61 to 5.07 (median filament index value 4.31/pressure value of 2 g/mm2). Three patients had delayed donor site wound healing.Conclusions:The free toe pulp flap is an efficient choice for fingertip and volar finger defects reconstruction with an excellent tissue match.

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Section: Discussionmentioning

confidence: 99%

Free toe pulp flap for finger pulp and volar defect reconstruction

Balan¹

2016

Indian J Plast Surg

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“…Therefore, pedicled aps remain important in reconstructive rst web-space surgeries. The rst dorsal metacarpal artery ap was commonly used for web-space defects (15,16). Doğan described new bio-geometric designs of rst dorsal metacarpal artery ap-bilobed or V-Y advancement ap-to reconstruct soft-tissue defects of the rst web-space and the proximal dorsal thumb (17).…”

Section: Discussionmentioning

confidence: 99%

First Web-space Reconstruction Using the Second Dorsal Metacarpal Artery Cutaneous Flap: A Reliable Choice for Large Defects

Tian

Guo

Han

et al. 2020

Preprint

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Background First web-space defect reconstruction is challenging for reconstructive surgeons. The second dorsal metacarpal artery (SDMA) flap is useful in treating hand and finger defects. However, limited studies have used it for the first web-space defects. This study reports a modified SDMA flap to treat first web-space soft-tissue defects. Methods From April 2012 to October 2018, 8 patients underwent a modified SDMA flap transfer (mean flap size, 2 × 3 cm to 4 × 6 cm). The average length of the pedicle was 2.9 cm. On average, the flap was rotated 84°. In 6 patients, full-thickness skin was grafted at the donor sites. The donor site was primarily closed in two cases. Results All wounds were healed without complications of flap failure or donor area-related morbidity. The average follow-up period was 7.9 months, and these patients were satisfied with the functional recovery and cosmetic appearance of the scar area. At the end of follow-up, the average movement range of the metacarpophalangeal joint of the thumb, index finger, and long finger were 84°, 88°, and 87°, respectively, while those of the contralateral thumb, index finger, and long finger were 87°, 88°, and 85°, respectively. The first web of the injured side spanned an average of 73°; the measurement on the contralateral side was 91°. Conclusions The SDMA flap reconstruction is a simple and fast procedure with a wide resurfacing range for large first web-space defects, low donor-site morbidity, and good functional and esthetic appearance.

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“…Using the ‘super Kutler technique’, we have reported a mean static two-point discrimination of 3.5 mm (range 3 to 5). In addition, we believe that the coaptation of the cut ends of the proper digital nerves may provide a convenient pathway for the regenerating axons from cut ends of the nerves and reduce the incidence of symptomatic neuroma formation (Sano et al, 2008; Wang et al, 2016).…”

Section: Discussionmentioning

confidence: 99%