Vascularized flap transfer to fingers with volar digital veins as recipient vessels

Chen, Chao; Wang, Zeng Tao; Li, Hao; Lijun, Yang; Liu, Huan Long

doi:10.1177/1753193419866413

Cited by 9 publications

(6 citation statements)

References 21 publications

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“…Such free flaps are often toe flaps, flaps from the foot or venous flaps from the forearm (Chen et al, 2019;Lee et al, 2020). For defects involving the very distal tip, a sensate toe flap is a good option, while defects more proximally on a digit may be repaired with a venous flap as the venous flap does not restore good sensation when it is harvested from the forearm.…”

Section: Soft Tissue Coverage For Finger Reconstructionmentioning

confidence: 99%

Soft and tissue repair of the hand and digital reconstruction

Adani

Tang

Elliot

2021

J Hand Surg Eur Vol

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This article summarizes the current views and proposed approaches to treating soft tissue defects of the hand. The article also outlines some key considerations of digital reconstruction. There are many options in treating soft tissue defects. For defects of the hand, local flaps are primarily considered if the defects are small or moderate in size. A vascularized free flap is only considered for a defect of large size (3 cm long or larger). Thumb reconstruction is of primary importance, while reconstruction of two fingers is necessary when all fingers are lost. Reconstructions of a missing distal part of a finger or reconstruction of an entire finger if only one finger is lost are cosmetic restorations; functionally these defects do not need reconstruction. Sensation is of great importance in repair or reconstruction of the tip of the thumb or finger. Therefore, sensory evaluation is a key factor in assessing and selecting the best options of surgery.

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Section: Soft Tissue Coverage For Finger Reconstructionmentioning

confidence: 99%

Soft and tissue repair of the hand and digital reconstruction

Adani

Tang

Elliot

2021

J Hand Surg Eur Vol

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“…However, local flaps are not always large enough to cover the defect. Therefore, various free flaps from distant areas are used, including toe-pulp flaps (Chen et al., 2019; Lee et al., 2008; Lin et al., 2007), first web space free flaps (Woo et al., 1999), medial planter flaps (Lee et al., 1998) and medialis pedis flaps (Rodriguez-Vegas., 2014). However, these flaps are harvested from a separate operative field.…”

Section: Introductionmentioning

confidence: 99%

An ulnar parametacarpal perforator flap for volar digital soft tissue reconstruction

Usami

Inami

Hirasé

et al. 2020

J Hand Surg Eur Vol

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We present outcomes of using a perforator-based ulnar parametacarpal flap in 25 patients for digital pulp defects. These included 17 free transfers to the thumb, index, middle and ring fingers and eight reverse pedicled transfers to the little fingers. This flap includes a dorsal sensory branch of the ulnar nerve, which was sutured to the digital nerve in all transfers. Each flap had one to three reliable perforators (mean 0.44 mm diameter) to the ulnar parametacarpal region and contained at least one perforator within 2 cm proximal to the proximal digital crease. All the 25 flaps survived completely. Twenty-two patients were followed for 15 months (range 12 to 24), and three were lost to follow-up. The mean static and moving two-point discrimination of the flap was 7 mm and 5 mm, respectively. At the donor site, sensory reinnervation was acceptable. We conclude that ulnar parametacarpal perforator flaps offer sensate, thick and glabrous skin for finger pulp repair, all in a single operative field. Level of evidence: IV

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“…The advanced and complex methods are undoubtedly useful and justified for tissue loss in complex digital trauma, of the entire hand, or with extensive defects more proximally. However, these microsurgical techniques are sometimes likewise employed in fingertip defects, and microsurgical free flap transfers have been used even for minor pulp reconstruction (Chen et al, 2019;Kim et al, 2013;Lee et al, 2020;Lin et al, 2007).…”

mentioning

confidence: 99%

Surgery in one region may be an ethical issue in other regions

Adani

2021

J Hand Surg Eur Vol

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Vascularized flap transfer to fingers with volar digital veins as recipient vessels

Cited by 9 publications

References 21 publications

Soft and tissue repair of the hand and digital reconstruction

Soft and tissue repair of the hand and digital reconstruction

An ulnar parametacarpal perforator flap for volar digital soft tissue reconstruction

Surgery in one region may be an ethical issue in other regions

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