Digital artery serial reverse island flaps for repairing fingertip degloving injuries of adjacent fingers

Abstract

Objective To investigate the effectiveness of using digital artery tandem reverse island flaps to repair fingertip degloving injuries of the adjacent fingers.Methods Between March 2009 and May 2011,11 cases of degloving injuries of the fingertip were treated using this procedure.Among these cases 5 involved the index finger,3 involved the middle finger,2 involved the ring finger and 1 involved the little finger.The sizes of skin and soft tissue defect ranged from 3.0 cm× 2.2 cm to 5.5 cm × 4.5 cm.The two island flaps were harvested along the same digital artery course and transferred to cover defects of the fingertip of adjacent fingers.Results Vascular spasm occurred in 1 case during flap harvesting which was alleviated by topical application of papaverine and warm saline.Postoperative blister appeared in 2 cases but disappeared after one week.The other flaps survived uneventfully and the wounds healed by first intention.The follow-up period ranged from 6 to24 months,being 12 months on average.All flaps presented the satisfactory shape and texture and recovered some sensation.The flexion and extension function of wounded fingers recovered to normal.According to the functional assessment criteria of the upper limb formulated by the Hand Surgery Society of Chinese Medical Association,the outcomes were graded as excellent in 6 cases,good in 4 cases,and fair in 1 case,with an excellent and good rate of 90.9％.Conclusion The digital artery tandem reverse island flaps for repairing fingertip degloving injury is a simple and effective procedure. Key words: Surgical flaps; Finger injuries; Series flap