Nail bed defect covered with labial mucosa graft after subungal glomus tumor removal

Abstract

The nail bed is an important part of the nail unit. It supports the nail plate, but does not regenerate itself. The labial mucosa and the nail bed both lack a granular layer. Because the keratinization of the nail bed can cause poor nail adhesion, harvesting graft from nonkeratinized sites is preferred. Furthermore, harvesting graft from labial mucosa is convenient in surgical approach. Therefore, the labial mucosa is more eligible for covering the nail bed defect than other graft methods. In this report, a 46-year-old female patient suffered from a subungal glomus tumor of the right fourth fingernail bed for 10 years. After the nail plate was removed, complete excision of the tumor was performed, and a labial mucosa graft was used to cover the defect. Eight months after the operation, the tumor had not reoccurred and no nail deformity was observed. This outcome demonstrates that our procedure is a good surgical option for treatment of nail bed defects.

Reversed distal laterodigital adipofascial flap for nail‐bed reconstruction

“…We considered the use of a distal adipofascial laterodigital flap with reversed blood supply on the basis of the vascular anatomy of the long fingers, primarily represented by the arterial and venous network of the palmar digital arteries (Losco et al, 2019). Following the principles of our previous study (Del Bene et al, 1994) and considering the findings of other authors (Levame et al, 1967;Oberlin & Le Quang, 1985) Various reconstructive options are available, such as radiodorsal fasciocutaneous flap of the thumb (Liu et al, 2013), vascularized nail-bed grafts from different sites (Tamai, 2003), muco-labial grafts (Kwon et al, 2013) other than a minimal wound debridement in order to avoid complications like the chronic deformations of the nail and the altered sensitivity of the finger as complications of the repaired nail bed (Ashbell et al, 1967;Flatt, 1955). The necessity of nail reconstruction is correlated to its important function in improving the quality of sensitivity by its compression effect and it is also a proficient tool for fine precision tip pinch without force.…”

“…Many previous studies focused on covering and reconstruction techniques of the amputated or damaged fingers, but only few on nail‐bed repairing. Various reconstructive options are available, such as radiodorsal fasciocutaneous flap of the thumb (Liu et al, 2013), vascularized nail‐bed grafts from different sites (Tamai, 2003), muco‐labial grafts (Kwon et al, 2013) and other techniques. Those different methods are based on the principle defined during the second half of the 20th century fist by Flatt and then by Ashbell et al based on a thorough cleansing of the injured digit and a meticulous repair of the lacerated nail‐bed, other than a minimal wound debridement in order to avoid complications like the chronic deformations of the nail and the altered sensitivity of the finger as complications of the repaired nail bed (Ashbell et al, 1967; Flatt, 1955).…”