The outcome of direct-flow neurovascular island flaps in pulp defects

Abstract

The transfer of direct-flow island flaps, from the same finger, causes minimal morbidity on the donor site and appears to be a safe method, providing satisfactory functional and aesthetic results in the reconstruction of pulp defects.

Predictors of Proximal Interphalangeal Joint Flexion Contracture After Homodigital Island Flap

“…Hand therapy and splinting have been used postoperatively in patients with finger stiffness, but a flexion contracture of the PIP joint occurred in 8% to 29% of cases. 9,10 In the current study, all patients were initially immobilized in 10 to 20 of PIP joint flexion, because of flap inset. Some patients overcame this during the healing process, but others did not.…”

Syndactylizing arterialized venous flaps for multiple finger injuries

“…A local flap is intended to cover the open areas of a finger's vital tissues, such as the tendons, nerves, and bones, but the traditional local flaps commonly used for single finger injuries may not be an option. These convenient flaps include direct‐flow homodigital neurovascular flaps; reverse‐flow, homodigital, dorsal, proximal phalanx skin flaps; and homo/heterodigital middle phalanx island flaps . Unfortunately, often in multi‐finger injuries, using any of the aforementioned flaps is not possible because of damaged donor areas.…”

“…[2][3][4][5][6][7][8][9][10][11][12][13] For complex multiple fingertip injuries, including palmar and dorsal longitudinal oblique defects, extending to the proximal end of the distal interphalangeal joint (DIP) crease cannot always be achieved using local homodigital/heterodigital island flaps due to accompanying soft tissue injuries and extension of injury zone to the donor area. 14 Partial skin necrosis after multiple finger replantation surgery, crush injuries, rolling belt injuries, dorsal friction injuries are the most common causes of complex soft tissue defects. The difficulty of covering these complex defects sometimes leads the surgeon to decide shortening of finger or making a stump in some institutions.…”

Esthetically successful fingertip reconstruction using a second toe pulp free flap with a split thickness skin graft and tattoo

“…Structural preservation is important as soft tissue and bone loss can result in detrimental hand disability. 1 Traditionally, simple revision amputation, skin graft, local flap or distant flap is used for reconstruction. 1,2 In the past, operative indications for a free flap on the fingertip were controversial; however, the recent development of supermicrosurgery, which has a high survival rate, has facilitated reconstruction of fingertip defects.…”

“…1 Traditionally, simple revision amputation, skin graft, local flap or distant flap is used for reconstruction. 1,2 In the past, operative indications for a free flap on the fingertip were controversial; however, the recent development of supermicrosurgery, which has a high survival rate, has facilitated reconstruction of fingertip defects. 3 We present an esthetically successful case of reconstruction of a fingertip defect and fingernail appearance by means of staged operations.…”