Functional sensory function recovery of random-pattern abdominal skin flap in the repair of fingertip skin defects

Abstract

The fingertip skin defect is a common hand injury often accompanied by tendon or bone exposure, and is normally treated with flaps. The aim of this study was to evaluate the functional sensory recovery of random-pattern abdominal skin flap in the repair of fingertip cutaneous deficiency. A total of 23 patients, aged between 18 and 50 years (mean age, 31 years) with fingertip cutaneous deficiency (30 digits) were treated with random-pattern abdominal skin flaps. The post-debridement defect area measured from 0.7×1.2 to 2.5×3 cm. The flap pedicle was divided three weeks after surgery, which marked the onset of the second stage. A second surgery was performed on 2 patients after 3 months and on another set of 2 patients after 6 months to create a thinner flap. Tissue was dissected during surgery for a histological examination. All the flaps survived and the post-operative follow-up ranged from 2 weeks to 6 months. Patients were satisfied with the appearance of their fingers and the flaps. All flaps demonstrated satisfactory flexibility and texture and sensory recovery was achieved. Only 4 patients were subjected to a second surgery to make the flap thinner. The flaps for the 3-month tissue section had several low-density, free nerve endings, whereas those of the 6-month section had more intensive free nerve endings, nerve tracts, tactile cells and lamellar corpuscles. Random-pattern abdominal skin flap therefore repairs fingertip skin defects achieving sensory recovery.

Application of a modified dorsoulnar artery pedicle flap in the repair of thumb tip defects: A case report

“…It would be prudent to restore sensory function when suturing the superficial radial nerve and the digital nerve (22). In previous studies, the flap nerve was directly sutured with the digital nerve stump, whereas the result was not satisfactory, especially for two-point discrimination test (9)(10)(11)(12)(13)(14). Similar findings were obtained in the present case report, though the thumb flap two-point discrimination was partially restored.…”

“…These flaps can be raised as adiposal-only flaps or extended flaps and supercharged through perforator-to-perforator anastomoses. For traumatic fingertip and finger stump reconstructions, digital artery perforator flaps deliver consistent aesthetic and functional results (7)(8)(9). Subsequently, numerous clinical trials have demonstrated that the thumb dorsoulnar artery pedicle flap is an effective technique to repair soft tissue defects (7)(8)(9)(10)(11)(12)(13)(14).…”

“…For traumatic fingertip and finger stump reconstructions, digital artery perforator flaps deliver consistent aesthetic and functional results (7)(8)(9). Subsequently, numerous clinical trials have demonstrated that the thumb dorsoulnar artery pedicle flap is an effective technique to repair soft tissue defects (7)(8)(9)(10)(11)(12)(13)(14). Ramirez and Gonzalez (15) described the local patterns of the thumb vascular anatomy of 30 fresh right hands from male and female cadavers using a vascular injection technique with methyl methacrylate, providing anatomical evidence for the pedicle flap design.…”

Outcome of free digital artery perforator flap transfer for reconstruction of fingertip defects

“…Fingertip defect, one of the most common injuries in the hand, is treated with various flaps such as random pattern abdominal flap and retrograde digital artery island flap. 1 2 3 4 5 However, swelling in the fingertip, dysfunction of sensation and scarring leads to restriction of flexion and extension. Injury to the hemi-artery of the finger usually occurs during the recovery stage.…”

SURGICAL MANAGEMENT OF DISTAL PHALANGEAL INJURIES OF FINGERS (review)

“…Все пациенты завершили исследова-ние в конце шестого месяца. Авторы проводили также морфологическое исследование препара-тов из лоскутов в различные периоды, обнару-жив разные стадии восстановления нервных окончаний и телец Пачини, Руффини и колб Краузе, отвечающих за определенные виды чув-ствительности [165]. По данным S. Woo и соавт.…”