Glabrous Flow-Through Flaps for Simultaneous Resurfacing, Revascularization, and Reinnervation of Digits

Chen, Chao; Hao, Liwen; Sun, Wenjuan; Wang, Zengtao; Ding, Zihai; Zhang, Shizhen

doi:10.1097/sap.0000000000000889

Cited by 8 publications

(7 citation statements)

References 23 publications

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“…However, this technique involved denting an otherwise noninjured finger, provided a limited recovery of sensibility, and needed cortical reorientation. 11 The main drawback of the cross finger flap, thenar flap, 14,15 and hypothenar flap 9 is the risk of flexion contracture of the finger due to the immobilization period. 8 Several attempts of an algorithmic approach to fingertip reconstruction options have been proposed based on level, size, shape, the direction of soft tissue defect, 24,25 and Allen classification.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The fingertip reconstructions with GTP flap documented in the literature suggest that one of the key factors for sensory recovery consists of an adequate nerve suture, 12 with nerve fascicle of similar number and quality as the recipient site 9,30,37 (Table 1). On the other hand, based on evidence concerning the spontaneous recovery of sensation in free flaps, [39][40][41] the fingertip reconstructions described in this study were performed without nerve suture, obtaining a 2PD average score of 9.41 mm.…”

Section: Discussionmentioning

confidence: 99%

“…5 The choice of the single modality among the multiple options of the reconstructive armamentarium depends not only on the characteristics and dimensions of the loss of substance but also on patient preference and wills, functional demanding and request, general condition, culture, and expertise of the surgeon. 9 Regarding the microsurgical reconstructive procedures, the first flaps harvested from the foot for the Related Digital Media are available in the full-text version of the article on www.PRSGlobalOpen.com.…”

Section: Introductionmentioning

confidence: 99%

“…The choice of the single modality among the multiple options of the reconstructive armamentarium depends not only on the characteristics and dimensions of the loss of substance but also on patient preference and wills, functional demanding and request, general condition, culture, and expertise of the surgeon. 9 …”

Section: Introductionmentioning

confidence: 99%

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To Do or Not to Do? Neurorrhaphy in Great Toe Pulp Flap Fingertip Reconstruction

Troisi

Stucchi

Vizcay

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Since its inception, the great toe pulp (GTP) flap has represented a valid therapeutic choice in the reconstruction of defects of the hand. This study illustrates the clinical outcomes of GTP free flaps performed without nerve anastomosis‚ mainly for fingertip defect reconstruction. Methods: We performed a retrospective, monocentric cohort study. All patients included in this study presented with fingertip traumatic injury, with tendon or bone exposure; reconstruction with GTP flap, without nerve reconstruction, was performed by the first author (L.T.) from May 2019 to October 2021. Results: All 37 flaps survived completely. Due to COVID restrictions‚ we had to send the tests and PROMs to our patients; 28 of them replied. Cold intolerance was reported by 12 patients (moderate in two cases and mild in ten cases). No pain was complained about either in hand or donor site (Visual Analog Score 0, at rest and at movement). Complete range of motion was achieved in 22 of 28 patients. All flaps recovered protective sensitivity. In every section of the Michigan Hand Outcome Questionnaire, all patients expressed a high level of satisfaction based on the reconstruction’s function and aesthetics. Regarding the donor site morbidity, no patient complained about gait disturbance. Conclusions: This study showed that the GTP flap is the optimal choice for fingertip reconstruction, providing excellent functional and aesthetic results with durable and glabrous skin, satisfactory pulp contour, and sensory restoration. These results could be achieved with no need for nerve suture, especially in defects with no injuries proximal to the loss of substance.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

To Do or Not to Do? Neurorrhaphy in Great Toe Pulp Flap Fingertip Reconstruction

Troisi

Stucchi

Vizcay

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Syndactylized glabrous flaps for multiple finger palmar defects

Güntürk,

Erol,

Gürbüz

et al. 2024

Microsurgery

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BackgroundPalmar finger or pulp defects require coverage with glabrous tissue to achieve a good match with the lost tissue. The management of multiple finger palmar or pulp defects is challenging because these defects may not always be suitable for local or pedicled flaps. In such situations, syndactylizing free or pedicled flaps can be used.Patients and methodsWe evaluated the results of free glabrous flaps syndactylizing across multiple finger defects. The two flaps used were the superficial branch of the radial artery (SUPBRA) flap and hypothenar free flap. Seven syndactylized glabrous free flaps were used to cover the defects in 16 fingers. The functional results and complaints were also assessed.ResultsMean flap size was 14.35 cm2. Six flaps survived. Postoperative evaluation data were obtained for the 13 fingers. All the patients returned to their previous work. All patients had a diminished protective sensation of at least 4.31 according to the SWM test. The mean two‐point discrimination score of the patients was 9.9 mm (7–14). One finger had a PIP joint flexion contracture of 30°, no donor‐site complaints were observed.ConclusionThe advantages of these flaps include single operation site, strong glabrous tissue coverage, low risk of flexion contracture, and adequate tissue size for large defects. Disadvantages include two‐stage and complex microsurgical operations, prolonged treatment, and hospital stay.

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Expanding indication of free hypothenar flap transfer: Sequential pedicled ulnar palm flap transfer to a relatively large hypothenar flap donor site

Yamamoto

Daniel

Kageyama

et al. 2022

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Glabrous Flow-Through Flaps for Simultaneous Resurfacing, Revascularization, and Reinnervation of Digits

Cited by 8 publications

References 23 publications

To Do or Not to Do? Neurorrhaphy in Great Toe Pulp Flap Fingertip Reconstruction

To Do or Not to Do? Neurorrhaphy in Great Toe Pulp Flap Fingertip Reconstruction

Syndactylized glabrous flaps for multiple finger palmar defects

Expanding indication of free hypothenar flap transfer: Sequential pedicled ulnar palm flap transfer to a relatively large hypothenar flap donor site

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