Treatment effectof application of retrograde dorsal island fasciocutaneous flap for repairing fingertip defects

Abstract

Objective To report the effect of the reverse island flap with the proximal dorsal phalangeal fascial pedicle for repairing fingertip defects. Methods A retrospective analysiswas made to 30 cases (30 fingers) with fingertip defects applied withthe reverse island flap with the proximal dorsal phalangeal fascial pedicle in the Hand And Foot Surgery department of Suzhou New District People’s hospital from January 2012 to December 2017including 24 males and 6 females, Aged from19 to 58 years old, average (36±12) years old. Among them, there were 12 cases of finger defect with bone exposure, 8 cases of finger skin soft tissue with distal nail and distal end of phalanx, 5 cases of fingertip skin and nail bed defect, 5 cases of more of nail bed defect with less amount of distal phalanx defects. The area of wound defect rangedfrom 3.0 cm×1.5 cm to 2.0 cm×0.5 cm.The design of skin flap is according to the defective area of fingertip .The flap pedicle is made of the radial or ulnar side of the dorsal phalangeal fascia tissue. The rotation point is not far away from the distal phalangeal joint plane. The flap pedicle was retrograded at 180 degree for repairing the fingertip defect. The donor site was repaired with free skin graft. Results 30 cases of 30 finger flaps were repaired after the operation. Among them, 25 fingers survived smoothly, 5 fingers had tension blisters after the operation, but the skin healed after dressing changing and the thread removing. During the follow-up 2 -12 months after the operation, the skin flaps had good appearance and texture, and the appearance of the flap and the finger was satisfied by the patients, and the flexion and extension function of the fingers recovered well. The two-point discrimination rate of the flap was 4 to 12 mm. Conclusion The blood supply of the clinical effect of the reverse island flap with the proximal dorsal phalangeal fascial pedicle is clear and the cutting of the flat is flexible and convenient without sacrificing the proper digital artery, it is an ideal method to repair fingertip defects. Key words: Distal finger defect; Island flap; Finger dorsum fasciae pedicle; Skin transplantation