Reverse Dorsal Digital Island Flap

Bene, Massimo Del; Petrolati, M.; Raimondi, Piero; Tremolada, Carlo; Muset, Alex

doi:10.1097/00006534-199493030-00017

Cited by 102 publications

(8 citation statements)

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Section: Discussionmentioning

confidence: 56%

“…We considered the use of a distal adipofascial laterodigital flap with reversed blood supply on the basis of the vascular anatomy of the long fingers, primarily represented by the arterial and venous network of the palmar digital arteries (Losco et al, 2019). Following the principles of our previous study (Del Bene et al, 1994) and considering the findings of other authors (Levame et al, 1967;Oberlin & Le Quang, 1985) Various reconstructive options are available, such as radiodorsal fasciocutaneous flap of the thumb (Liu et al, 2013), vascularized nail-bed grafts from different sites (Tamai, 2003), muco-labial grafts (Kwon et al, 2013) other than a minimal wound debridement in order to avoid complications like the chronic deformations of the nail and the altered sensitivity of the finger as complications of the repaired nail bed (Ashbell et al, 1967;Flatt, 1955). The necessity of nail reconstruction is correlated to its important function in improving the quality of sensitivity by its compression effect and it is also a proficient tool for fine precision tip pinch without force.…”

Section: Discussionmentioning

confidence: 99%

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Reversed distal laterodigital adipofascial flap for nail‐bed reconstruction

et al. 2023

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BackgroundLesions of the distal phalanges of the fingers frequently involve the nail bed. There are few therapeutic options for nail‐bed reconstruction and they often lead to painful scars and onychodystrophy. We present our experience with the distal adipofascial laterodigital reverse flap.MethodsFifteen patients (average age 46.33 years, range 28–73) with tumors or traumatic injuries (crush injuries, nail avulsion, and partial fingertip amputations) of the nail bed, underwent digital reconstruction through the distal adipofascial laterodigital reverse flap from June 2018 to August 2019. The size of the fingertip defect covered with the flap was ranged between 1.1 × 1.1 and 1.6 × 1.2 cm (average size 1.4 × 1.2 cm). The flap was harvested enrolling subcutaneous tissue from the lateral aspect of the middle and distal phalanx from the less damaged side.ResultsThe average size of the harvested flaps was 1.3 × 1.2 cm (range 1.1 × 1.0 to 1.4 × 1.1 cm). All adipofascial flaps survived entirely and the nail bed healed in all patients, with an average healing time of 21 days and a subsequent regrowth of the nail. The follow up ranged from 6 to 12 months, with a mean of 7 months.ConclusionsThe distal reverse adipofascial flap provides a very versatile and reliable coverage of the distal finger and its nail bed. It is a rapid and reproducible surgical procedure with poor morbidity for the donor site.Level of EvidenceIV.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Reversed distal laterodigital adipofascial flap for nail‐bed reconstruction

et al. 2023

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“…26,27 Pelissier described in his work of 27 cases the use of different flaps depending on the site of the defect. 26,27 On the contrary, we used one flap that has a specific blood supply detected by Doppler, which has the freedom to cover any moderate-size defect on the distal phalanx volar or dorsal aspect. In our series, we used a retrograde island digital artery perforator flap that was intended to cover fingertip defects.…”

Section: Discussionmentioning

confidence: 99%

“…25 Sometime before this era, Bene et al and Pelissier et al described the use of the reversed dorsal digital island flap to cover defects on the dorsal and dorsolateral aspects of the finger, which was based on communicating branches between the volar and dorsal arterial supply of the digit as per their description. 26,27 Pelissier described in his work of 27 cases the use of different flaps depending on the site of the defect. 26,27 On the contrary, we used one flap that has a specific blood supply detected by Doppler, which has the freedom to cover any moderate-size defect on the distal phalanx volar or dorsal aspect.…”

Section: Discussionmentioning

confidence: 99%

The Qatari Flap for Fingertip Reconstruction: Versatility, Reliability, Clinical Applications, and Review of Literature

Al Lahham,

Aljassem,

Alyazji

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Fingertip injuries are common; when the bone is exposed, it requires more than skin to cover the defect. After the introduction of the concept of perforator flaps, trials have been made to reconstruct finger defects with perforator flaps. Here, we describe a series of fingertip injuries that were treated with reverse flow island finger perforator flap. Methods: We had 36 patients from January 2019 to June 2021, most of them male workers. We reported on the sizes of the defects and donor sites, the need to cover the pedicle with a skin graft, and complications. Patients were followed up for a period of 6 months, and the detailed elevation technique was mentioned. Results: Thirty-four flaps survived completely. In 50% of the cases, patients had congestion and epidermolysis with preserved underlying flap, which had normal healing course. Two patients with diabetes had infections; one of them had 40% necrosis of the flap, and one additional case had superficial eschar with preserved underlying flap tissues. Conclusions: Fingertip reconstruction rather than bone shortening is preferred to maintain the finger length. Multiple choices were suggested, but this flap had the disadvantage of limited coverage. After introducing the concept of perforator flaps into finger reconstruction, still more choices were added. The retrograde island digital artery perforator flap is a reliable choice, which is done in one stage and does not require loss of the digital artery.

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“…The DBDA then sends out several secondary branches to supply soft tissue in the dorsal and lateral areas of the finger 5 . The 4 largest DBDAs are located at the middle and distal thirds of the proximal, middle of the middle phalanx, and the distal interphalangeal joint 6–9 . The original diameters of the 4 dorsal branches are 0.1 to 0.5 mm 10 .…”

Section: Methodsmentioning

confidence: 99%

Innervated Reconstruction of Fingertip Degloving Injury Using a Dorsal Digital Perforator Flap Combined With a Cross-Finger Flap

Wang

et al. 2022

Ann Plast Surg

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BackgroundThe reconstruction of a fingertip degloving injury presents a functional and aesthetic challenge. We used a dorsal digital perforator flap combined with a cross-finger flap to reconstruct this type of injury. The purposes of this retrospective study were to evaluate the efficacy of the combined flaps and to present our clinical experience.MethodsFrom November 2016 to October 2019, 16 patients (13 men and 3 women) with fingertip degloving injuries were treated with a dorsal digital perforator flap combined with a cross-finger flap for innervated reconstruction. We used an innervated dorsal digital perforator flap for the reconstruction of the dorsal defect of the degloved fingertip and an innervated cross-finger flap for the volar defect. The average size of the defect was 4.2 × 1.9 cm. The average sizes of the flaps were 2.3 × 2.1 cm (the dorsal digital perforator flap) and 2.5 × 2.1 cm (the cross-finger flap).ResultsAll flaps and skin grafts survived completely without ischemia or venous congestion. All wounds and their donor sites healed primarily without exudation and infection. Patients were followed up for a mean time of 11.3 ± 1.9 months (range, 9–15 months). At the final follow-up, no significant difference was seen in the averaged total active motion between the injured fingers and the contralateral fingers. No significant difference was found in the averaged total active motion between the donor fingers and the contralateral fingers. All flaps obtained excellent or good sensory performance. All flaps had mild cold intolerance. Thirteen patients had no pain, 2 reported mild pain, and 1 experienced moderate pain. Ten patients were very satisfied with the appearance of the reconstructed finger.ConclusionsThe dorsal digital perforator flap combined with a cross-finger flap is an effective and reliable method for the reconstruction of fingertip degloving injuries.

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Reverse Dorsal Digital Island Flap

Cited by 102 publications

References 0 publications

Reversed distal laterodigital adipofascial flap for nail‐bed reconstruction

Reversed distal laterodigital adipofascial flap for nail‐bed reconstruction

The Qatari Flap for Fingertip Reconstruction: Versatility, Reliability, Clinical Applications, and Review of Literature

Innervated Reconstruction of Fingertip Degloving Injury Using a Dorsal Digital Perforator Flap Combined With a Cross-Finger Flap

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