Dorsal pentagonal island flap to reconstruct post-burn interdigital web

Abstract

Introduction This study reports the use of a dorsal pentagonal island flap for post-burn webbing contracture, in which the islanded flap is harvested from the burn scar tissue. Methods Fourteen dorsal pentagonal island flaps were harvested in seven patients with post-burn webbing. Each flap was selected by examining the scar tissue donor using a modified Vancouver scar scale. Modification from the basic design was made according to the density of the donor scar tissue and the metacarpophalangeal joint movement. Results All the flaps survived with normal abduction of the affected fingers. Modification of the flap design needed adjustment by assessing it through flexion and extension of the metacarpophalangeal joints. There was no incidence of web creep after two months to one year of follow-up. Conclusion Dorsal pentagonal island flap shows promising results as an alternative for reconstructing post-burn webbing.

Concepts in soft-tissue reconstruction of the contracted hand and upper extremity after burn injury

“…Instead, fresh tissue must be brought in. A variety of options exist for this including posterior rectangular flaps ( 108 ), side of the finger rectangular flaps ( 107 ), pentagon ( 109 ), hourglass ( 110 ) or rhomboid flaps. Similar to interdigital contracture, these can be treated by a similar technique as described for congenital syndactyly ( Figure 6 ).…”