Simultaneous Three-Flap Reconstruction of Extensive Hand and Finger Degloving Injury: Case Report

Henry, Mark; Levaro, Fernando; Masson, Marcos; Clifton, Jorge

doi:10.1055/s-2002-33021

Cited by 8 publications

(9 citation statements)

References 19 publications

(21 reference statements)

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“…Consequently, the second option is reconstruction with flaps for coverage of exposed tendon and bone, such as local flaps, perforator free flaps, and arterialized venous flaps. [5][6][7][8][9][10] However, these flaps could not achieve satisfactory functional and esthetic results.…”

Section: Discussionmentioning

confidence: 99%

“…3 However, the majority of these injured digits are not suitable for replantation and would need secondary reconstruction with other options. 1,2,[5][6][7][8][9][10][11][12][13][14][15][16] Various flaps have been proposed in the literature, such as groin flap, random abdominal flap and local pedicled flaps, 1,[12][13][14] for reconstruction of the degloved fingers. Meanwhile, with the advent of microsurgery, fascial free flaps, fasciocutaneous sensitive flap, posterior interosseous free flaps, or even innervated arterialized venous flaps have been introduced for reconstruction.…”

mentioning

confidence: 99%

“…Meanwhile, with the advent of microsurgery, fascial free flaps, fasciocutaneous sensitive flap, posterior interosseous free flaps, or even innervated arterialized venous flaps have been introduced for reconstruction. [5][6][7][8][9][10] However, the results with insensibility, bulk, and poor blood supply from those options remained unsatisfactory with complications.…”

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confidence: 99%

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Free great toe wrap‐around flap combined with second toe medial flap for reconstruction of completely degloved fingers

Rui¹,

Mi²,

Shi³

et al. 2010

Microsurgery

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Surgical procedure of great toe wrap-around flap combined with second toe medial flap free transfer for reconstructing completely degloved fingers was introduced. The treatment outcomes were evaluated. 10 fingers in 7 cases were involved in this series. The great toe wrap-around flap with dorsalis pedis skin covered the dorsal and most palmar side of the injured finger. The second toe medial flap covered the proximal palmar portion of the finger. The combined flap was revascularized with nerve repair. Rehabilitation started two weeks postoperatively. All flaps survived except one was partial failure due to distal phalange necrosis. Recipient areas achieved primary wound healing in 9 fingers. Skin graft at donor site achieved primary survival except delayed healing in one case. All patients were followed-up from 34 to 76 months. The appearance of reconstructed fingers was satisfactory. Nail growth well except that one nail was the atrophic and another was defect. Range of active motion in the metacarpophalangeal joint was from 60° to 80° and the proximal interphalange joint was 40° to 70°. Two-point discrimination was between 8 mm and 12 mm. All patients walked with no interference. There was no pain and no swelling at donor site. According to the results, this procedure is recommended to reconstruct total degolving finger which has intact phalanges and tendons.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Free great toe wrap‐around flap combined with second toe medial flap for reconstruction of completely degloved fingers

Rui¹,

Mi²,

Shi³

et al. 2010

Microsurgery

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“…If the skin is torn, the effect is the creation of a large flap of full-thickness skin. In either case, massive sloughing is likely unless the injury is properly managed [7,10,15].…”

Section: Discussionmentioning

confidence: 99%

Degloving Injury

2005

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European Journal of Trauma Ab stractBackground: Degloving is a potentially serious injury in which an extensive area of skin is torn from its underlying attachments and thereby deprived of its blood supply. Case Study: Two cases of degloving injury are described, one occurring as a result of the shearing effect of a vehicle wheel passing over the limb in a run-over accident and one caused by a ring of the fourth-hand finger. The degloved skin must be grafted with the help of plastic surgery either by removing the subcutaneous fat from the damaged skin and applying it as a free graft or by taking a graft from elsewhere. Conclusion: Degloved skin is dead and should be replaced as if it were a free skin graft. A number of plastic surgical procedures are available at the moment. IntroductionDegloving injuries cause stripping of skin and underlying tissues from the bones, usually of the hands or feet, as occurs in run-over accidents, wringer or industrial roller injuries [3,22,46,48]. These two cases of degloving injury of the lower limb and the fourth finger of the right hand, respectively, are presented in order to describe this rare and potentially very serious injury of soft tissue.

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“…However, they may not cover extensive defects that involve the dorsal and palmar hand, particularly without a time-consuming delay procedure or tissue expansion [8]. Paired groin and abdomen flaps have been described since the 1970s [2,5,[9][10][11][12][13][14][15][16][17][18], which are better suited to extensive and three-dimensional wounds.…”

Section: Introductionmentioning

confidence: 99%