Abstract
Introduction: the traumatic injuries of the hand are in the top of the list of industrial working accidents. The treatment of these injuries has as goal to restore the function of the fingertip, improving the life quality of the patients. Objective: to evaluate results of the application of neurovascular homodigital flaps on the cutaneous defects of the digital fingertip of the large fingers of the hand. Method: it was perform an observational and descriptive type investigation, in a case chain of 33 patients on the Hermanos Ameijeiras Hospital in the period of October 2013 up to January 2015, were it was apply neurovascular homodigital flaps with direct circulation (17 patients) or indirect circulation (16 patients). Results: male sex was more affected, with a higher frequency between 36 and 41 years old and also over 41 years old. There was confirmed 4 complications representing the 12%. It was obtained a 72.7% of good and excellent results with the application of these surgical techniques getting an appropriate protector sensibility and a satisfactory cutaneous covering. The patients were satisfied in a 93.9% of the cases with the application of these procedures. Conclusions: it was demonstrated the efficiency of the application of neurovascular homodigital flaps on the cutaneous defects of the digital fingertip of the large fingers of the hand.
Highlights
The frequency of hand injuries in industrialized countries represents a third of all accidents
In the center in question, the homo-digitized neurovascularized island flaps are used because the transferred tissue satisfies the requirements of the reconstruction of the pulp, both from the mechanical and the sensitive point of view, providing a satisfactory protective sensitivity to the receptor area without affecting the main sensitivity of the donor finger, which motivated us to evaluate the results of its application taking into account age, sex, type of amputation, production mechanism, occupation and time of evolution and incorporation to work
The sample consisted of 33 patients with complex loss of substance from the long fingers of the hand with surgical criteria of monopedicular neurovascularized homodigital flaps on an island, applying direct circulation flaps to 17 patients (Fig. 1) or indirect circulation to 16 patients (Fig. 2)
Summary
The frequency of hand injuries in industrialized countries represents a third of all accidents. Hand injuries are often treated by inexperienced surgeons, which explains a large part of the aftermath after the accident. There are multiple surgical procedures to treat losses of complex substance from the digital pulp: targeted healing, free skin graft, Kutler and Atasoy flaps, and neurovascularized homodigital flaps. In the center in question, the homo-digitized neurovascularized island flaps are used because the transferred tissue satisfies the requirements of the reconstruction of the pulp, both from the mechanical and the sensitive point of view, providing a satisfactory protective sensitivity to the receptor area without affecting the main sensitivity of the donor finger, which motivated us to evaluate the results of its application taking into account age, sex, type of amputation, production mechanism, occupation and time of evolution and incorporation to work. The objective of our research is not to compare methods but to present the results of our experience since the procedures that we apply, in addition to providing adequate skin coverage, provide a satisfactory protective sensitivity to the receiving digital pad
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