Partial Second Toe Pulp Free Flap for Fingertip Reconstruction

Lee, Dong Chul; Kim, Jin-Soo; Ki, Sae Hwi; Roh, Si Young; Yang, Jae Won; Chung, Kevin C.

doi:10.1097/01.prs.0000299945.03655.0d

Cited by 106 publications

(102 citation statements)

References 18 publications

Supporting

Mentioning

102

Contrasting

Order By: Relevance

“…12 The convex contour of the toe pulp is similar to that of the finger pulp. [19][20][21] However, because the donor site of lateral first-toe flap may require a skin graft for resurfacing, 19 patients who undergo the procedure may be dissatisfied with the painful and unsightly scar in the donor site, which would be visible when wearing open-toed sandals. The MPAP flap meets the above criteria, and the similar anatomic characteristics of the plantar surface make it the preferred donor site for fingertip reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Free medial plantar artery perforator flap for finger pulp reconstruction: Report of a series of 10 cases

Huang

Lai

et al. 2009

Microsurgery

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Free medial plantar artery perforator flap for finger pulp reconstruction: Report of a series of 10 cases

Huang

Lai

et al. 2009

Microsurgery

View full text Add to dashboard Cite

show abstract

“…Lastly, hand elevation and rubber drainage also increase the flap outflow but reduce the flap inflow as well. 12 In contrast to digital arterial, thenar, cross-finger, abdominal, and free flaps, distally based dorsal digital fasciocutaneous flap with venoneuroadipofascial pedicle is superior in the following aspects.…”

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

View full text Add to dashboard Cite

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.

show abstract

“…Free pulp or hemipulp transfers' sensory results are excellent [9,22], but these results could be also obtained by local flaps. Lee et al points out that a high proportion of the reconstructed fingers need additional surgeries [31].…”

Section: Discussionmentioning

confidence: 99%

“…However, there is a consensus that replantation is the best choice by maintaining the length of the finger and the normal anatomy of the nail complex, if only the amputated fragment is available, in replantable condition and well preserved [34,42]. If replantation is not possible, reconstruction ladder could be used for fingertip injuries: secondary healing, primary closure, skin grafting, homodigital flaps (V-Y advancement [4], V-Y cup [41], dorsal visor [20], Kutler [25], Moberg [35], hatchet [4], Hueston [10], linguiform rotation [12], dorsal adipofascial flaps [26,28,40], cross-finger flap [20,25], island flaps (homodigital [5,7,13,29,38], heterodigital [30] and metacarpal [19]) (antegrade and retrograde [38]), digital artery perforator flaps [23], distant flaps (thenar flap [10], groin and abdominal), free flap (free toe pulp [9,22,31], venous [33,39] and medial plantar perforator [17,42]). …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Bilateral V–Y Rotation Advancement Flap for Fingertip Amputations

Sungur¹,

Kankaya²,

Yıldız

et al. 2012

Hand (New York, N,Y.)

View full text Add to dashboard Cite

Background Fingertip amputation is the most common type of injury in the upper limb. Goals in fingertip amputation reconstruction are covering the defect, establishing maximum tactile gnosis, keeping the length of the finger, protecting the joint function, acquiring a well-padded pulp tissue, providing a bed for growing nail, obtaining a satisfactory cosmetic appearance and allowing the patient to return to work as soon as possible. Adjacent skin and soft tissue are the best covers for fingertip injuries. However, local homodigital flaps lack enough tissue to cover the defect. To solve this problem, we used V-Y rotation advancement flap bilaterally in fingertip amputations which meets all the reconstruction goals. Rotation besides advancement makes this flap more mobile and easier to cover larger defects in all amputation planes. Methods Between 2007 and 2009, we performed bilateral V-Y rotation advancement flap on seven male patients' pulpa (average age, 37.6 years) whose fingertips were not replantable.Results Fourteen flaps were made on 7 fingers. There was neither total nor partial flap loss. Patients had neither cold intolerance nor scar hypersensitivity. Stiffness of the PIP joint did not occur. No obvious hooked nail occurred in patients who have remaining nail matrix. Because flaps contain neurovascular bundle, there was no difference in sensation and perfusion between the finger's pre-operative and post-operative status. The result was satisfactory with painless pinching. Conclusion In addition to the various and versatile fingertip reconstruction methods, we want to present V-Y rotation advancement flap as a quick, reliable and aesthetic method.

show abstract

Partial Second Toe Pulp Free Flap for Fingertip Reconstruction

Abstract: The shorter pedicle and smaller flap can reduce the surgical time and morbidity associated with this procedure. This flap is the authors' first line of treatment for covering fingertip wounds by transferring similar pulp tissue from the toe to the finger.

Cited by 106 publications

References 18 publications

Free medial plantar artery perforator flap for finger pulp reconstruction: Report of a series of 10 cases

Free medial plantar artery perforator flap for finger pulp reconstruction: Report of a series of 10 cases

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

Bilateral V–Y Rotation Advancement Flap for Fingertip Amputations

Contact Info

Product

Resources

About