Dorsal Digital Artery Island Flap is an Effective Technique for Coverage of Finger Defect

Abstract

Background: Reconstruction of soft tissue defects in fingers is a challenging problem and continues to evolve. A variety of flaps for reconstructing small-to-moderate defects have been described, but none is beyond drawbacks. The purpose of this study is to report and to evaluate the efficacy of the use of dorsal digital island flaps (DDIF) for the reconstruction of finger defects. Materials and Methods: The study was conducted from January 2020 to September 2021 in the Burn and Plastic Surgery Department at Rajshahi Medical College Hospital. A total of 10 DDIF, based on either proximally or distally, were done in 9 patients. Most of the causes of defects were electrical burns. All flaps survived with minimal complications to the donor finger. Results: Among 10 digits, the mean defect size was 4.24 (±2.34) cm2, ranging from 1.92 to 5.95 cm2. Defects were observed: 4 in middle fingers, 3 in thumb, 2 in ring fingers, and one in index finger. 6 fingers were in right hand. DDIF covered the defects on volar (5 cases), dorsal (4 cases), and both (1 case) surfaces. According to site, one case had defect on proximal phalanx with 3rd web space, 4 instances had on proximal phalanx, defect involving on both proximal and middle phalanx was in one case and rest 4 cases had defect on distal phalanx. Among 10 DDIF, 7 (70%) flaps were survived without any loss. Rest 3 (30%) cases had marginal necrosis (less than 2 mm loss) but did not require further procedure. Conclusion: DDIF is a reliable and effective option for finger defect coverage.