The Clinical Effect of Digital Dorsal Fascial Island Flap Combined With Crossfinger Flap for Repairing Distal Degloving Injury and Sensory Reconstruction

Abstract

BackgroundTo explore the clinical effect of digital dorsal fascial island flap combined with crossfinger flap to repair distal degloving injury and sensory reconstruction.MethodsA total of 19 patients with distal fingertip degloving injuries treated with digital dorsal fascial island flap combined with crossfinger flap in our hospital from April 2018 to August 2020 were retrospectively included. Semmes–Weinstein (SW) monofilament and static two-point discrimination (S-2PD) tests, active range-of-motion (ROM) of the fingers, cold intolerance, visual analog scale (VAS) score patient complications, and patient satisfaction were evaluated.ResultsFive cases with post-operative flap blisters were treated at the time of dressing changes until successful scab formation. Three cases with post-operative arterial crisis of finger arterial dorsal branch vessel were relieved after suture removal and tension reduction. All other skin flaps and skin grafts survived. Nineteen patients received follow-up between 3 and 26 months (average 14.6 months). The active ROM of metacarpophalangeal (MCP) and interphalangeal (IP) joints of the injured fingers were satisfactory.ConclusionThe digital dorsal fascial island flap combined with the crossfinger flap for repairing the distal degloving injury of the distal segment of the finger is a good surgical method, which is simple and easy to operate, can repair a large area of soft tissue defect, and obtain a satisfactory effect.

Repair of Finger Pulp Defect and Sensory Reconstruction Using Reverse Homodigital Artery Island Flap With Palmar Cutaneous Branches of the Proper Digital Nerve

“…The digital dorsal flap combined with the cross-finger flap is an effective and reliable method, which can be used to repair the fingertip degloving injury. However, 3 weeks of immobilization and a second operation are still unavoidable 13,14 . V-Y advancement flap is appropriate for a small soft-tissue defect, which can obtain satisfactory wear resistance, appearance, and sensory recovery without causing damage to the donor area 15 .…”

“…However, 3 weeks of immobilization and a second operation are still unavoidable. 13,14 V-Yadvancement flap is appropriate for a small soft-tissue defect, which can obtain satisfactory wear resistance, appearance, and sensory recovery without causing damage to the donor area. 15 Although the technique remains one of the most secure and popular reconstructive options with overall good results, it should not be advanced more than 15 mm distally.…”