Repair of donor site of reverse digital artery island flap with transverse V-Y fascial advancement flap of proximal dorsum of the finger

Abstract

Objective To summarize the clinical efficacy of transverse V-Y fascial advancement flap of proximal dorsum of the finger for the repair of the donor site of reverse digital artery island flap. Methods From January 2017 to February 2018, 14 patients with fingertip defect were treated, including 4 emergency cases and 10 sub-emergency cases. The range of fingertip defect was 1.6 cm×0.6 cm to 2.5 cm×1.4 cm. The fingertip wound was repaired by reverse digital artery island flap and the donor site was covered by transverse V-Y fascial advancement flap of proximal dorsum of the finger. Results The flaps survived uneventfully after operation, and all the donor and recipient wounds achieved primary healing. The follow-up period ranged from 9 to 15 months with an average of 10.6 months. The skin flaps were of good texture, color, shape and no tenderness at the fingertips. At the last follow-up, the two-point discrimination of reverse digital artery island flaps was 7 to 12 mm, with an average of 8.6 mm. The two-point discrimination of V-Y advancement flaps of dorsal fingers was 5 to 9 mm, with an average of 6.2 mm. There was no web contracture, and the maximum abduction angle was 38° to 45° with an average of 42°. According to the total active range of motion (TAM) system, 12 cases were excellent and 2 cases were good. Conclusion The transverse V-Y fascial advancement flap of proximal dorsum of the finger was used to repair the donor site of reverse digital artery island flaps. The appearance, function and sensation of the fingers recovered well, and the related complications of free skin grafting were avoided. Key words: Finger injuries; Surgical flaps; Donor site; Wound repair