Use of the First Dorsal Metacarpal Artery-Based Fascial Flap for Reconstruction of Small Defects on the Dorsum of the Hands

Zhang, Xu; Shao, Xinzhong; Shen, Qiang; Yu, Yadong; Li, Yanchuang; Fan, Anwei

doi:10.1016/j.jhsa.2019.02.013

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…The contraindications of this technique include overlapped injuries to the donor region or to the pathway of the rst dorsal metacarpal artery. The rst dorsal metacarpal artery ap is also limited by the small size (up to 4 cm), which may not be large enough to cover most of its hand defects (18). Zhang et al described the use of the SDMA ap to repair thumb defects.…”

Section: Discussionmentioning

confidence: 99%

First Web-space Reconstruction Using the Second Dorsal Metacarpal Artery Cutaneous Flap: A Reliable Choice for Large Defects

Tian

Guo

Han

et al. 2020

Preprint

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Background First web-space defect reconstruction is challenging for reconstructive surgeons. The second dorsal metacarpal artery (SDMA) flap is useful in treating hand and finger defects. However, limited studies have used it for the first web-space defects. This study reports a modified SDMA flap to treat first web-space soft-tissue defects. Methods From April 2012 to October 2018, 8 patients underwent a modified SDMA flap transfer (mean flap size, 2 × 3 cm to 4 × 6 cm). The average length of the pedicle was 2.9 cm. On average, the flap was rotated 84°. In 6 patients, full-thickness skin was grafted at the donor sites. The donor site was primarily closed in two cases. Results All wounds were healed without complications of flap failure or donor area-related morbidity. The average follow-up period was 7.9 months, and these patients were satisfied with the functional recovery and cosmetic appearance of the scar area. At the end of follow-up, the average movement range of the metacarpophalangeal joint of the thumb, index finger, and long finger were 84°, 88°, and 87°, respectively, while those of the contralateral thumb, index finger, and long finger were 87°, 88°, and 85°, respectively. The first web of the injured side spanned an average of 73°; the measurement on the contralateral side was 91°. Conclusions The SDMA flap reconstruction is a simple and fast procedure with a wide resurfacing range for large first web-space defects, low donor-site morbidity, and good functional and esthetic appearance.

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Section: Discussionmentioning

confidence: 99%

First Web-space Reconstruction Using the Second Dorsal Metacarpal Artery Cutaneous Flap: A Reliable Choice for Large Defects

Tian

Guo

Han

et al. 2020

Preprint

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“…Several reconstructive options such as local, regional and free flap transfers have been used including the dorsal metacarpal artery (DMA) flaps [2][3][4]. In particular, the use of the first DMA flap has been widely reported in the indexed literature for the repair of deep soft tissue defects of the thumb [5][6][7][8][9]. However, one of the drawbacks of this flap is related to donor site morbidity, since the donor site defect which remains on the dorsum of the index finger, requires skin graft for coverage from a second donor site [10].…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of a soft tissue defect of the thumb using a modified dorsal metacarpal artery flap: A case report study

Konstantinidis¹,

Kotsias²,

Giotis³

et al. 2021

Int. J. Sci. Res. Arch.

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Finger injuries to the hand with extensive soft tissue defects might be challenging to treat. Typically, the first dorsal metacarpal artery (DMA) flap is used for reconstruction, whereas closure of the donor site is routinely performed with a split-thickness skin graft. The aim of the current study is to present a surgical technique that reports a modified incision, which allows elevation of the first DMA flap for the management of the soft tissue defects of the thumb without requiring a skin graft for coverage of the donor site. A 65-year-old man presented to the emergency department with a crush injury to the thumb. The patient had an extensive skin defect on the dorsal side of the thumb extending circumferentially to the ipsilateral thenar without tendon damages, whereas sensation of the finger was found intact. Surgical intervention was performed within six hours and involved DMA flap transfer through a modified skin incision, which allowed coverage of the donor defect in the index finger with a second DMA perforator flap. 3 months postoperatively, patient’s satisfaction, sensation and range of motion (ROM) of the fingers were assessed using The Michigan Hand Outcomes Questionnaire (MHQ) and the 2-point discrimination (2-PD) test. The patient regained active ROM of the thumb and index along with complete preservation of sensation, while the final cosmetic outcome was satisfactory. The application of this technique allows coverage of both trauma defect and donor site with a single skin incision, providing a successful clinical outcome.

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Radial Artery

Bauder

Steinberger

Amotz

et al. 2021

Recipient Vessels in Reconstructive Microsurgery

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Use of the First Dorsal Metacarpal Artery-Based Fascial Flap for Reconstruction of Small Defects on the Dorsum of the Hands

Cited by 3 publications

References 14 publications

First Web-space Reconstruction Using the Second Dorsal Metacarpal Artery Cutaneous Flap: A Reliable Choice for Large Defects

First Web-space Reconstruction Using the Second Dorsal Metacarpal Artery Cutaneous Flap: A Reliable Choice for Large Defects

Reconstruction of a soft tissue defect of the thumb using a modified dorsal metacarpal artery flap: A case report study

Radial Artery

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