Aesthetic and Sensory Reconstruction of Finger Pulp Defects Using Free Toe Flaps

Abstract

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A Systematic Review of Outcomes and Complications of Primary Fingertip Reconstruction Using Reverse-Flow Homodigital Island Flaps

“…Local flaps replace tissues ''like-with-like,'' but these flaps are limited to small-sized defects [21][22][23][24]. Various other methods of reconstruction have been used, including homodigital island flaps [1][2][3][4][5][6][7][8][9][10][11][12][13][14][25][26][27][28][29], cross-finger flaps [29][30][31], thenar flaps [32], and toe free flaps [33,34]. However, none has yielded entirely satisfactory results.…”

Secondary restoration of fingertip sensation with Littler's heterodigital neurovascular island flap after ring avulsion injury: Report of two cases

“…A free toe pulp flap, first described by Buncke and Rose [14], led to satisfactory results because of good sensation restoration at the host site and limited morbidity [15,16]. But, this technique could not be performed here because of the large nerve defect.…”

Anastomosis to the common and proper digital vessels in free flap soft tissue reconstruction of the hand

“…Additionally, they can revascularize otherwise devascularized tissues and remain soft and supple for improved function . Furthermore, patients have been shown to have a shorter recovery . Free flaps to the hand were traditionally anastomosed to large vessels at the volar wrist (radial or ulnar artery) or snuff box (dorsal branch of radial artery) .…”

“…Microvascular free flaps are the most versatile soft tissue reconstructive tool. They can cover complex defects of varying sizes, improve venous and lymphatic drainage of the traumatized area, and are associated with earlier return to work and higher functional and aesthetic satisfaction . Current teaching and literature suggests that these free flaps be anastomosed to proximal wrist vessels (radial artery, dorsal branch of the radial artery, and ulnar artery) .…”

“…They can cover complex defects of varying sizes, improve venous and lymphatic drainage of the traumatized area, 1 and are associated with earlier return to work and higher functional and aesthetic satisfaction. 2 Current teaching and literature suggests that these free flaps be anastomosed to proximal wrist vessels (radial artery, dorsal branch of the radial artery, and ulnar artery). [3][4][5][6][7] This is traditionally done to be further away from the zone of injury, the ability to perform an easier and faster anastomosis by working with larger diameter vessels, and to have increased blood flow to meet the metabolic requirements of these free flaps.…”