A Distant Fasciocutaneous Chest Wall Skin Flap for Necrotic Finger Post Reimplantation: A Case Report

Abstract

The hand is often compromised by scars or potentially necrotic wounds. Complete loss of index finger will result in impairment of 20% of hand and 11% of whole-person. One of the most influential factors in consideration of tissue loss are defect size, site, depth, and orientation. In our case study, a 16-year-old male presented with sensations of tingling and pain in his finger subsequent to an accidental laceration. Examination revealed a necrotic wound located on the distal phalanx of the index finger, accompanied by mild atrophy and discoloration. Subsequently, the patient underwent graft harvesting from the right chest wall flap, followed by primary closure of the donor site on the right chest wall. Upon a three-month follow-up, the patient expressed satisfaction, demonstrating proficient daily activities despite the injury being localized to the left hand. Utilizing a chest wall flap is less prevalent than employing regional or free flaps. Anterior chest wall flaps are specifically crafted on the anterolateral chest wall or within the infraclavicular region. The choice of a chest wall flap was determined to offer a less cumbersome graft and aligns with the patient's preference. The main goal of soft tissue reconstruction is to restore functionality, encompassing tasks such as exploration, sensation, and manipulation of objects, while simultaneously preserving the original length. Nonetheless, achieving this goal remains a complex challenge. Keywords: Necrotic finger, Reimplantation, Chest Wall Skin Flap, Soft Tissue Reconstruction