Modified homodigital dorsolateral proximal phalangeal island flap for the reconstruction of finger-pulp defects

Qin, Hongjiu; Ma, Nengfeng; Du, Xing; Kong, Jian; Wang, Haisheng; Xu, Lei; Hu, Bin

doi:10.1016/j.bjps.2020.08.061

Cited by 10 publications

(15 citation statements)

References 25 publications

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“…(1) The digital dorsal fascial island flap and the cross-finger flap pedicle include the dorsal branch of the proper digital artery of the middle finger segment and surrounding fascial tissues, with rich blood supply, reliable blood circulation, and high survival rate. (2) The flap is easy to dissect without damaging the main nerve and vessels ( 15 , 24 ). (3) The skin flap was removed from the tissue around the adjacent wound.…”

Section: Discussionmentioning

confidence: 99%

“…The rotation point was located on the lateral side of the transverse palmar striations of the distal interphalangeal (DIP) joint. The vascular pedicle was the dorsal branch of the digital artery and its surrounding fascia was about 0.5 cm in width ( 14 , 15 ), and the pedicle was 0.8–1.0 cm in length. The opposite side of the pedicle should not exceed the midline of the contralateral side.…”

Section: Methodsmentioning

confidence: 99%

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The Clinical Effect of Digital Dorsal Fascial Island Flap Combined With Crossfinger Flap for Repairing Distal Degloving Injury and Sensory Reconstruction

et al. 2022

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BackgroundTo explore the clinical effect of digital dorsal fascial island flap combined with crossfinger flap to repair distal degloving injury and sensory reconstruction.MethodsA total of 19 patients with distal fingertip degloving injuries treated with digital dorsal fascial island flap combined with crossfinger flap in our hospital from April 2018 to August 2020 were retrospectively included. Semmes–Weinstein (SW) monofilament and static two-point discrimination (S-2PD) tests, active range-of-motion (ROM) of the fingers, cold intolerance, visual analog scale (VAS) score patient complications, and patient satisfaction were evaluated.ResultsFive cases with post-operative flap blisters were treated at the time of dressing changes until successful scab formation. Three cases with post-operative arterial crisis of finger arterial dorsal branch vessel were relieved after suture removal and tension reduction. All other skin flaps and skin grafts survived. Nineteen patients received follow-up between 3 and 26 months (average 14.6 months). The active ROM of metacarpophalangeal (MCP) and interphalangeal (IP) joints of the injured fingers were satisfactory.ConclusionThe digital dorsal fascial island flap combined with the crossfinger flap for repairing the distal degloving injury of the distal segment of the finger is a good surgical method, which is simple and easy to operate, can repair a large area of soft tissue defect, and obtain a satisfactory effect.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

The Clinical Effect of Digital Dorsal Fascial Island Flap Combined With Crossfinger Flap for Repairing Distal Degloving Injury and Sensory Reconstruction

et al. 2022

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“…12 Finally, an island flap with a neurovascular pedicle can also be used to cover the fingertips; this type of flap does not require the long fixation time required for cross flaps and allows for the recovery of sensation in the fingertips. 13 The repair of fingertip defects with artery island flaps is a relatively simple and safe operation and is an ideal treatment of relatively large fingertip wounds. The RDAF is widely used in clinical practice 14 and requires one digital artery to be sacrificed.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of the Clinical Effects of Reverse Digital Artery Island Flaps and Antegrade Homodigital Neurovascular Island Flaps for Fingertip Reconstruction

Xiong

Ming

et al. 2021

Ann Plast Surg

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Objective: This retrospective study aimed to compare the clinical effects of reverse digital artery island flaps and antegrade homodigital neurovascular island flaps in fingertip reconstruction. Patients and Methods: We retrospectively analyzed the data of 30 consecutive patients with fingertip defects who had undergone 2 types of surgery from January 2016 to January 2019. We used reverse digital artery island flaps and antegrade homodigital neurovascular island flaps in 14 and 16 patients, respectively. Flap sensitivity was evaluated using the Semmes-Weinstein monofilament test and static 2-point discrimination test. Finger appearance was assessed using the Michigan Hand Outcomes Questionnaire. The operation time, flap sensitivity, range of motion of the interphalangeal joint, and complications were evaluated. Results: The static 2-point discrimination results of the fingers were significantly different between the antegrade homodigital neurovascular island flap group and reverse digital artery island flap group (8.07 ± 1.54 vs 5.94 ± 1.73; P < 0.05). The appearance of the fingers was significantly better in the antegrade homodigital neurovascular island flap group. Surgery using antegrade homodigital neurovascular island flaps required less time than surgery using reverse digital artery island flaps. No significant differences were found between the 2 groups in the range of motion of the interphalangeal joint or complications. Conclusions: The functional outcomes were identical between the reverse digital artery island flap and antegrade homodigital neurovascular island flap methods for fingertip reconstruction. Antegrade homodigital neurovascular island flaps lead to a shorter operation time, a more satisfying appearance, and better sensory recovery.

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“… 0 2019 Appukuttan et al 29 DAP Unilateral V-Y advancement flap - lateral perforator 10 (6M:4F) / 10 26.5 (1- 52) 9 crush, 1 sharp 3 IF, 3MF, 4LF 14 to 80 mm 2 10 DAP Unilateral V-Y 3-4 mm (7 pts) 3 (1-8) 7 satisfied, 1 not (nail contour) All survived. 2020 Qin et al 21 Modified dorsolateral proximal phalangeal island flaps 16(14M:2F) / 16 48.8 (30-57) 16 crush, 3 sharp, 8 avulsions 7 IF, 8 MF, 10 RF, 2 LF 15 × 13 to 27 × 20 16 MDPP DIPJ 74.8 +/- 6.2 8.0 +/- 1 8.7 (5 -12) MHQ 85 +/- 3.7 6.3 +/- 1.2 wks 13 full survival, 2 transient venous congestion, 1 partial distal loss due to congestion 0 Homodigital dorsal DAP flaps 11 (9M:2F) / 11 49.3 (39-58) 18 × 14 to 25 × 20 11 Dorsal DAP DIPJ 75 +/- 4.6 8.5 +/-1.3 8.4 (6-13) MHQ 85.9 +/- 3 6.5 +/- 1.1 wks 9 survived fully, 2 venous congestion with flap survival 2020 Ayhan et al 39 (IDAP flap) island flap as per Ozcanli technique – lateral perforators 15(14M:1F) 17/21 47.2+/-12.9 (26-62) 3 saw, 14 crush 17 IDAP DIPJ 77.3+/- 3.5 (70-80) 2.83- 4.93 6.4 (3- 10) 13.8 (7-18) 9 satisfied, 8 Highly satisfied 22.5 (15-30) Days All survived, Superficial necrosis 3 (2 patients) healed secondarily with dressings 0 2020 Dionyssiou et al 22 DADAP- adipofacial with SSG (rotation advancement) (dorsal defect + exten...…”

Section: Methodsmentioning

confidence: 99%

Homodigital Pedicled Digital Artery Perforator flaps for fingertip reconstruction - a review of flap options

Khan

Appukuttan²,

Loh³

2022

JPRAS Open

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Modified homodigital dorsolateral proximal phalangeal island flap for the reconstruction of finger-pulp defects

Cited by 10 publications

References 25 publications

The Clinical Effect of Digital Dorsal Fascial Island Flap Combined With Crossfinger Flap for Repairing Distal Degloving Injury and Sensory Reconstruction

The Clinical Effect of Digital Dorsal Fascial Island Flap Combined With Crossfinger Flap for Repairing Distal Degloving Injury and Sensory Reconstruction

Comparative Study of the Clinical Effects of Reverse Digital Artery Island Flaps and Antegrade Homodigital Neurovascular Island Flaps for Fingertip Reconstruction

Homodigital Pedicled Digital Artery Perforator flaps for fingertip reconstruction - a review of flap options

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