The Gigogne Flap: An Original Technique for an Optimal Pulp Reconstruction

Abstract

The reconstruction of digital pulp defects is still a challenge in hand surgery. Several reconstructive techniques are available, but in some cases, their advancement capacities are not sufficient for the flap to cover the whole defect. The Gigogne flap is a new, very simple and safe technique. It consists of harvesting two cutaneous flaps successively on the same neurovascular digital palmar bundle. The first plasty may be chosen among the well-known flaps usually applied in pulp reconstruction. The second plasty, the Gigogne flap, is an advancement VY plasty done on the main cutaneous paddle of the first proximal flap. We performed 15 Gigogne flaps in 13 patients, who suffered zone II and III digital pulp amputations. The Gigogne flap increased the advancement capacity of the proximal flap as well as restoring the physiological pulp fatty pad, thus reconstructing a functional and aesthetic fingertip.

A Systematic Review of Outcomes of Revision Amputation Treatment for Fingertip Amputations

“…The abstract and title review narrowed the field to 124 studies that underwent full text review. Upon further review, 38 studies met the inclusion/exclusion criteria [1–9, 12–18, 21, 22, 25–30, 32, 35, 37, 39–41, 43–47, 49, 50, 52] (Table 1). The included studies were published between 1972 and 2011, and a total of 1,009 fingertip amputations were treated.…”

“…The included studies were published between 1972 and 2011, and a total of 1,009 fingertip amputations were treated. Twenty-seven studies reported 2PD outcomes [2, 3, 6, 8, 9, 14, 16, 18, 21, 25–27, 29, 30, 32, 35, 37, 39–41, 43, 45–47, 49, 50, 52], 20 studies reported cold intolerance outcomes [1–3, 6, 7, 9, 14, 17, 22, 28–30, 39, 41, 43–45, 47, 49, 50, 52], eight studies reported AOM outcomes [5, 9, 21, 22, 40, 43, 44, 50], and 18 studies reported return-to-work time [4, 7, 12–17, 21, 22, 25, 28, 29,…”

“…In addition, there is considerable variability in techniques used for fingertip revision amputation. Eighteen studies used the homodigital island flap [1-3, 6, 14, 15, 21, 26-29, 37, 40, 43, 44, 47, 49, 52], whereas seven studies reported V-Y advancement flap [4,5,17,18,39,41,46] and another two studies reported cross-finger flap treatment [9,46]. Three studies treated fingertip amputations with dressings and allowed wounds to heal by secondary intention [13,16,30].…”

Management of soft tissue defects of the thumb

“…Small soft tissue defects that require less than 5 mm of advancement can be covered readily by local advancement with palmar V-Y plasty, bilateral V-Y plasty, or modifications thereof [14][15][16] . The choice is based on the preference and experience of the surgeon, as all flaps are equally effective.…”

An Evolutionary Perspective on the History of Flap Reconstruction in the Upper Extremity

“…137 The Gi-gone flap harnesses an island pedicle-based axial supply in a double V-Y advancement reminiscent of Atasoy's concept. 138 Boomerang flaps combine the concepts of reversed flow and perforator flaps. 139 Even smaller and more technically challenging island flaps have arisen with the digital artery perforator flaps.…”