The reverse dorsal metacarpal artery flap in finger reconstruction: A reliable choice

Abstract

Background:The finger skin and soft-tissue defects are reconstructive challenges due to their nature and the intricate extensor apparatus and flexors it protects. The reverse dorsal metacarpal artery (RDMA) is a time-tested option for the reconstruction of the same.Materials and Methods:A total of 14 cases of RDMA flap for finger defects involving proximal to distal phalanx were performed. Thirteen of these patients were male and one patient female and the most common mode of injury was occupational in nature followed by road traffic accident. The overall appearance was assessed for the flap and the donor site. The associated injuries and the range of motion were noted.Results:All but one flap survived completely. One patient had partial distal flap loss, which was tackled with split-thickness skin grafting. The flap size varied from 3.5 cm × 1.5 cm to 9 cm × 2 cm with mean of 6.64 cm × 1.72 cm. The mean age of the patients was 33.4 years. All the patients had acceptable aesthesis. The donor site had no complications and healed with linear scar.Conclusions:RDMA flap is a reliable flap for finger defects reconstruction. The range of movement mainly depends on the associated injury rather than flap transfer alone and to prove this we require doing analysis of range of movement in patients with flap done alone or with associated injuries.

Re: The reverse dorsal metacarpal artery flap in finger reconstruction: A reliable choice

“…Sir, We read with great interest the article titled, ' A novel method to insert drain atraumatically after liposuction in gynaecomastia' by Sunil Gaba, and we congratulate the authors. [1] We agree with the authors that, also liposuction, even when combined with glandular resection, has an important role in the surgical treatment of gynaecomastia, for flattening the thorax, eliminating fat residuals and creating a controlled shrinking of the cutaneous flat to recontour the male chest area. Seromas is one of the most common complications when liposuction is included in gynaecomastia surgical correction.…”

“…They have exemplified its utility in a wide spectrum of dorsal finger defects, providing a simple single stage cover with like tissue without any donor site morbidity. [1] However, the authors describe this flap being based on retrograde flow through the dorsal metacarpal artery (DMA) through communicating perforators, while in the surgical procedure described, they have not mentioned that they have raised the flap with the DMA. That implies that the flap is based on a perforator.…”

Colgajo de la primera arteria metacarpiana dorsal: revisión y aplicación clínica de una técnica clásica

“…(7) En respuesta a esta duda, Maruyama (8) y Lu y Wan (9) aseguran que estas comunicaciones eran numerosas y suficientes, al menos en el primer y segundo espacios interóseos. (10) Con esta información Maruyama introdujo el primer colgajo metacarpiano reverso, ampliando el arco de rotación de los colgajos distales.…”

Dorsal Metacarpal Artery Flap: An Underrated Workhorse Flap for Reconstruction of Dorsal Finger Defects

“…Venous congestion is another problem with the DMCA flaps due to twisting, kinking, or occlusion of the pedicle, especially the veins. Fortunately, this can be overcome by preserving a generous cuff of subcutaneous tissue around the pedicle during flap harvest, by avoiding tunneling the flap through a skin bridge, and postoperatively removing all constricting sutures, through observation and regular follow-ups [ 5 , 18 ].…”