Additional advancement after elevation of a neurovascular advancement flap with interposition of an artificial nerve conduit

Abstract

A neurovascular advancement flap is a useful procedure for fingertip reconstruction, but there is a limit to the advancement distance. 1 Varitimidis S.E. Dailiana Z.H. Zibis A.H. Hantes M. Bargiotas K. Malizos K.N. Restoration of function and sensitivity utilizing a homodigital neurovascular island flap after amputation injuries of the fingertip. J Hand Surg Br. 2005; 30: 338-342 Crossref PubMed Scopus (32) Google Scholar Among these flaps, an oblique triangular flap, which is based on a unilateral neurovascular bundle, can be transferred a distance of approximately 15 mm. 2 Usami S. Kawahara S. Yamaguchi T. Hirase Y. Homodigital artery flap reconstruction for fingertip amputation: a comparative study of the oblique triangular neurovascular advancement flap and the reverse digital artery island flap. J Hand Surg Eur. 2015; 40: 291-297 Crossref Scopus (36) Google Scholar However, the acceptable distance differs in specific cases; sometimes there is a shorter possible advancement distance mainly due to limited lengthening of the digital nerve. To resolve this problem, we suggest artificial nerve conduit interposition in the pedicle of the neurovascular bundle of the advancement flap. Letter comments on: Additional advancement after elevation of a neurovascular advancement flap with interposition of an artificial nerve conduitJournal of Plastic, Reconstructive & Aesthetic SurgeryVol. 72Issue 12PreviewWe congratulate the authors on this impressive technique for significantly lengthening the reach of the V to Y pattern (Venkataswami) flap by dividing and lengthening the digital nerve with a collagen conduit1. Full-Text PDF