Maximal advancement of homodigital neurovascular island flaps

Abstract

We investigated the maximal advancement of the homodigital neurovascular island flap with the digit in full extension and its correlation to the digital length. In 32 adult cadaveric digits, flaps measuring 1 × 1 cm were sequentially elevated to different dissection points. Dissection of the flap to the proximal interphalangeal joint crease, palmo-digital crease, division of adjacent digital artery and the superficial arch resulted in flap advancement of 8, 12, 15 and 18 mm, respectively. The degree of advancement correlated to the length of the finger and was approximately 19% of the finger length. We conclude that dissection of a homodigital antegrade neurovascular island flap to the proximal interphalangeal joint, palmo-digital crease, after ligation of adjacent digital artery and the superficial arch allows progressively more advancement. The advancement obtained by flap dissection to the palmo-digital crease was about 19% of the finger length.

Parallelogram flap versus homodigital island flap in the treatment of fingertip defects with bone exposure: a prospective controlled study

“…We harvested the flap from the palmar side of the finger and pushed the flap forward to cover the wound. The flap includes a lateral proper digital artery and a digital nerve [ 17 ]. The parallelogram flaps do not need to require stripping the artery, After a careful preoperative design of the parallelogram flap, we abandon the finger’s width and retain the length, successfully achieving the purpose of the operation and reduce the operation time.…”

An ulnar parametacarpal perforator flap for volar digital soft tissue reconstruction

“…For ideal soft tissue reconstruction of the volar surface of the digit, glabrous skin with similar texture, contour, suitable thickness, durability for pinch and grip and, if possible, the ability to restore sensation, is required. Traditionally, antegrade volar advancement flaps, homodigital reverse pedicle flaps, heterodigital neurovascular island flaps and cross-finger flaps have been commonly used (Elliot et al., 2018; Germann et al., 2017; Lam and Jordan, 2019; Lim et al., 2019; Omokawa, 2019; Tang et al., 2014; Tos and Adani, 2019). However, local flaps are not always large enough to cover the defect.…”

A survey of three surgical teams regarding past and present options for digital pulp restoration

“…The two flaps are easy to harvest and can be advanced farther to avoid hook deformities. These flaps are considered to be workhorses in many countries (Lim et al., 2019; Omokawa, 2019). Sometimes, a larger defect is treated with a Venkataswami flap for part of the defect, combined with semi-occlusive dressing for the remainder.…”