A Novel Approach for Reconstruction of Finger Neurocutaneous Defect: A Sensory Reverse Dorsal Digital Artery Flap from the Neighboring Digit

Feng, Shi-Ming; Sun, Qingqing; Cheng, Jiamin; Wang, Aiguo

doi:10.1111/os.12350

Cited by 5 publications

(5 citation statements)

References 31 publications

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“…In Feng's study, finger soft tissue defects were repaired using a sensory reverse dorsal digital artery flap from an adjacent digit, which was based on dorsal branch of the digital artery and two dorsal branches of the proper digital nerves. 27 The result of s2PD at 24 months of follow-up was 6.5 mm, which was also similar to ours. However, due to the drawbacks of lesion of adjacent digits and sensory loss on the dorsal side of the proximal and middle phalanges, they concluded that that flap was an effective option for finger tissue defect reconstruction when local and regional flaps was not feasible.…”

Section: Discussionsupporting

confidence: 90%

“…reported an average s2PD value of 5.9 mm in their innervated reverse digital artery flap with bilateral neurorrhaphy, which was similar to our result of 5.8 mm. In Feng's study, finger soft tissue defects were repaired using a sensory reverse dorsal digital artery flap from an adjacent digit, which was based on dorsal branch of the digital artery and two dorsal branches of the proper digital nerves 27 . The result of s2PD at 24 months of follow‐up was 6.5 mm, which was also similar to ours.…”

Section: Discussionsupporting

confidence: 72%

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Reverse digital artery island flap with versus without sensory nerve coaptation for finger pulp reconstruction

Yuan

Wang

et al. 2022

ANZ Journal of Surgery

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Purpose Whether an innervated reverse digital artery island flap is superior to a non‐innervated reverse digital artery island flap still remains controversial. We aimed to compare the clinical outcomes of the two flaps in repairing finger pulp soft tissue defects. Methods Medical records of patients who underwent finger pulp reconstruction between January 2007 and December 2017 were evaluated retrospectively. A total of 45 patients were included. Twenty underwent sensory nerve reconstruction with cutaneous branches of the proper digital nerve, and 25 underwent the surgery without sensory nerve reconstruction. Surgical results, complications and sensory function were collected for analysis. Sensory function was assessed by static two‐point discrimination and the modified sensory evaluation standard of British Medical Research Council. Results The average operation time of innervated flaps was 23 min longer than non‐innervated flaps. All 45 flaps survived completely. There was no significant difference in complications between groups. The average follow‐up was 22 months. At the final follow‐up, five non‐innervated flaps had no recovery of static two‐point discrimination. The average static two‐point discrimination of the remaining 20 non‐innervated flaps was larger than that of innervated flaps. Innervated flaps consistently achieved higher sensory function grades according to the modified sensory evaluation standard of British Medical Research Council. Conclusion An innervated reverse digital artery island flap can achieve better sensory function recovery in a shorter time. This procedure did not increase the incidence of complications, although it extended the operation time. It has proven to be a good technique for finger pulp reconstruction.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 72%

Reverse digital artery island flap with versus without sensory nerve coaptation for finger pulp reconstruction

Yuan

Wang

et al. 2022

ANZ Journal of Surgery

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“…Zhao et al and Feng et al used this flap on 18 and 16 patients, respectively. The average size of the cutaneous defect to be covered was 25-31 mm in length and 19 mm in width [17]. Our results therefore appear to be consistent with mean skin flap dimensions of 33 mm in length and 21 mm in width, making it feasible to cover defects of the same order of magnitude.…”

Section: Discussionsupporting

confidence: 81%

Pedicled flap from the first dorsal branch of the proper palmar digital artery of the fingers: An anatomy study

Wolf-Mandroux

Detammæcker

Almeida

et al. 2020

Hand Surgery and Rehabilitation

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“…It is important to preserve the nerve supply of the flap to have good sensation postoperatively. 7,23,30,[32][33][34][35] There is no definite answer regarding which nerve to select when performing the reverse digital artery island flap procedure. Both the dorsal digital nerve and the dorsal branches of the proper digital nerve were commonly used in island flap to cover the finger defects.…”

Section: Discussionmentioning

confidence: 99%

“…In the study by Chen et al, 31 the innervated reverse dorsal homodigital island flap has been reported to have better sensation than the noninnervated flap. It is important to preserve the nerve supply of the flap to have good sensation postoperatively 7,23,30,32–35 . There is no definite answer regarding which nerve to select when performing the reverse digital artery island flap procedure.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2023

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ObjectiveTo illustrate the clinical outcomes of the reverse digital proper artery island flap with anastomosing the palmar cutaneous branches of the proper digital nerve for the reconstruction of finger pulp defects.MethodsFrom December 2007 to December 2017, a total of 20 patients with finger pulp defects were treated with reverse digital proper artery island flap for innervated construction. Functional outcomes, aesthetic appearance, and complications were evaluated. Functional outcomes were assessed according to range of motion, sensory grade (S0–S4), static 2-point discrimination, Semmes-Weinstein monofilament test, and Cold Intolerance Severity Score. Aesthetic appearance was evaluated according to the Michigan Hand Outcomes Questionnaire.ResultsAll flaps survived completely without any complications, and all patients were followed up for at least 12 months. The average static 2-point discrimination, Semmes-Weinstein monofilament, and Cold Intolerance Severity Score results of the injured fingers were 6.35 mm (range, 5–8 mm), 3.64 (range, 2.83–4.17), and 19 (range, 8–24), respectively. All patients achieved recovery in sensation from S3+ to S4. The active ranges of motion of the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints of the affected fingers were satisfactory. Based on the Michigan Hand Outcomes Questionnaire, 11 patients were strongly satisfied, and 9 were satisfied with the appearance of the injured finger.ConclusionsThe reverse digital proper artery island flap with anastomosing the palmar cutaneous branches of the proper digital nerve is an effective and reliable alternative for the reconstruction of finger pulp defect. In the recovery of sensation, this flap leads to satisfactory effects.

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A Novel Approach for Reconstruction of Finger Neurocutaneous Defect: A Sensory Reverse Dorsal Digital Artery Flap from the Neighboring Digit

Abstract: The sensory reverse dorsal digital artery flap from the neighboring digit, based on the dorsal branch of the digital artery, is an effective and additional option for finger neurocutaneous defect reconstruction when use of the local and regional flaps is not feasible.

Cited by 5 publications

References 31 publications

Reverse digital artery island flap with versus without sensory nerve coaptation for finger pulp reconstruction

Reverse digital artery island flap with versus without sensory nerve coaptation for finger pulp reconstruction

Pedicled flap from the first dorsal branch of the proper palmar digital artery of the fingers: An anatomy study

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

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