Partial medial second toe pulp free flap and dermal substitute with skin graft for salvage reconstruction of a complete skin envelope degloving of the small finger

Calafat, V.; Strugarek, C.; Montoya-Faivre, D.; Dap, F.; Dautel, G.

doi:10.1016/j.anplas.2018.03.001

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…The occurrence of scalds, stabs, and cut, would be inevitable, if sensation of fingertip was lost. The restoration of nerves may be one of the main features, and the medial dorsal nerve of the second toe from the deep peroneal nerve can be anastomosed to the nerve of the recipient site (Calafat et al, 2018). From the postoperative follow‐up, the sensory recovery of the flap is more successful than that of other flaps without innervation.…”

Section: Discussionmentioning

confidence: 99%

The modified second toe flap technique based on the dorsal digital artery of the toe in finger pulp reconstruction

Jin

Zhang

et al. 2023

Microsurgery

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BackgroundThe second toe flap is a widely used innervated neurovascular flap for repairing finger pulp defects. It mainly carries the proper plantar digital artery and nerve. But the donor site morbidity and arterial injury are common. The report retrospectively evaluated the clinical outcomes of the second toe free medial flap based on dorsal digital artery of the toe to investigate the esthetics and function in the treatment of soft tissue defects of fingertip pulp.MethodsFrom March 2019 to December 2020, 12 patients with finger pulp defects (seven acute crush, three cut, and two burn) undergoing the modified second toe flap were chosen for retrospective review. The average patient age was 38.6 (range: 23–52) years. The mean defect size was 2.1 × 1.6 (range: 1.5 × 1.3–2.6 × 1.9) cm. The defects did not extend beyond the distal interphalangeal joint and the phalanges were not damaged in all cases. The average follow‐up was 9.5 (range: 6–16) months. Demographic information, flap data, and perioperative characteristics were collected.ResultsThe mean size of the modified flap was 2.3 × 1.8 (range: 1.7 × 1.5–2.7 × 2.0) cm and mean diameter of artery was 0.61 (range: 0.45–0.85) mm. The mean flap harvested time and operation time were 22.6 (range: 16–27) minutes and 133.7 (range: 101–164) minutes. A flap was ischemic after first day postoperatively and later it improved by releasing the sutures. All flaps were survival without necrosis. One patient was not satisfied with the appearance of the finger pulp because of scar hyperplasia. The other 11 patients were satisfied with the appearance and function of the injured digit after 6 months postoperatively.ConclusionThe modified second toe flap technique based on the dorsal digital artery of the toe is a feasible choice to reconstruct the sensation and appearance of the injured fingertip with current microsurgical techniques.

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Section: Discussionmentioning

confidence: 99%

The modified second toe flap technique based on the dorsal digital artery of the toe in finger pulp reconstruction

Jin

Zhang

et al. 2023

Microsurgery

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“…It is also possible that the time required to skeletonize the pedicle could be saved because the pedicle of PSTP flaps is short. Moreover, nerve innervation is so fast with this approach that sensory recovery can be excellent (Calafat et al, 2018; Lee et al, 2008). Finally, primary closure of the donor site is possible since it is a partial flap using only half of the pulp of the second toe.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, reconstruction of the fingertip using a free flap from the toe may help preserve sensation (Lee, Park, et al, 2012; Morrison et al, 1980; Rui et al, 2010). In particular, if partial second‐toe pulp (PSTP) is chosen for transplant, it could use the short pedicle and reduce donor‐site morbidity (Calafat et al, 2018; Lee et al, 2008). PSTP free flap can produce good results and reduce surgical time when an experienced surgeon performs.…”

Section: Introductionmentioning

confidence: 99%

Partial second‐toe pulp free flap for fingertip reconstruction: Experience and surgical tips to minimize complications

et al. 2021

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Background Traumatic fingertip injury is a common hand injury and various methods are available to address them. The partial second‐toe pulp (PSTP) free flap is useful because of the similarity in shape, texture, and sensation to the fingertips. However, there may be many difficulties during surgery. The purpose of this report is to make the surgery easier and minimize complications by sharing the surgical tips of the authors obtained through many experiences. Patients and Methods Thirty patients who underwent PSTP free flap due to trauma were reviewed retrospectively from February 2015 to June 2018. The average age of the patients was 49.4 years. Seventeen were injured on the right side and 13 were on the left side. After removal of the injured tissue, a teardrop‐shaped flap was harvested from the medial side of the second toe. When inset, skin graft or vein graft was performed if necessary. When primary closure of the donor site was difficult, skin graft was performed (n = 21). The factors noted during surgery were analyzed. Results The flap size was 2.39 (range: 1.5–5) x 1.29 (range: 1–1.8) cm2. All flaps survived. Venous congestion was found in two patients, neuroma was found in one patient, and partial necrosis was found in two patients; all recovered with conservative care. The mean follow up periods was 5.79 (range: 2–18) months. None of the patients had functional impairment. Conclusion Successful reconstruction and enhanced functional and cosmetic effects can be achieved using surgical tips.

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Clinical effect of thumb finger reconstruction using dorsal foot flap transplant for treating thumb defects

et al. 2020

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Partial medial second toe pulp free flap and dermal substitute with skin graft for salvage reconstruction of a complete skin envelope degloving of the small finger

Cited by 3 publications

References 10 publications

The modified second toe flap technique based on the dorsal digital artery of the toe in finger pulp reconstruction

The modified second toe flap technique based on the dorsal digital artery of the toe in finger pulp reconstruction

Partial second‐toe pulp free flap for fingertip reconstruction: Experience and surgical tips to minimize complications

Clinical effect of thumb finger reconstruction using dorsal foot flap transplant for treating thumb defects

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