Application of proper digital artery island flaps of adjacent digit for repair of finger soft tissue defects and reconstruction of blood circulation

Abstract

Objective To research the surgical procedure and clinical effects of proper digital artery island flaps of adjacent digit for repair of finger soft tissue defects and reconstruction of blood circulation. Methods From March 2010 to May 2015, 21 cases of finger soft tissue defects were treated with proper digital artery island flaps of adjacent digit. The artery or nerve defect ranged from 1.5 to 4.0 cm. The skin and soft tissue defects area ranged from 1.5 cm×1.0 cm to 4.0 cm×2.0 cm. During the operation, proper digital artery and its island flaps were obtained from adjacent side margin of adjacent digit, and transferred to repair skin and soft tissue defects and reconstruct blood circulation simultaneously. The nerve defect was bridged by forearm or foot dorsal cutaneous nerve graft. Results Vasospasm occurred in 2 cases during intraoperative dissection, which was relieved after local application of papaverine and hot warm saline. Vascular crisis occurred in one case 2 hours after the operation, which was relieved by operative exploration. The rest flaps survived uneventfully. The follow-up period ranged from 6 to 48 months with the average being 18 months. The appearance and texture of the flaps were good. Partial protective sensations were restored. The original appearance and function of the injured finger were recovered. No dysfunction occurred in donor fingers. According to the functional evaluation standards issued by Hand Surgery Society of the Chinese Medical Association, the results were excellent in 13 cases, good in 6 cases, fair in 2 cases. Conclusion Application of proper digital artery island flaps of adjacent digit for repair of finger soft tissue defects and reconstruction of blood circulation not only has the clinical effect of flow-through flap, but also has the advantages of simplicity, safety and reliability, which is worth promoting. Key words: Finger injuries; Surgical flaps; Flow-through flaps; Transfer repair