Digital Artery Perforator Research Articles

Digital artery perforator flaps: an easy and reliable choice for fingertip amputation reconstruction

The aim of this study was to evaluate the use and efficacy of digital artery perforator (DAP) flaps in fingertip reconstruction. From 2007 to 2011, 7 fingers of 5 patients (4 male, 1 female) underwent fingertip reconstruction with extended DAP flaps following traumatic fingertip amputation. Average flap size was 4.25 cm². All flaps survived except one case in which partial skin necrosis was observed and treated with wet-dressing. Donor sites were closed with full-thickness skin grafting in 5 and primarily in 2 fingers. We did not observe hypersensitivity or cold intolerance in repaired fingers. The DAP flap is a reliable, free-style perforator flap that can be used for all types of fingertip injuries.

The little finger ulnar palmar digital artery perforator flap: anatomical basis

The aim of this study was to explore the cutaneous vascularization of the hypothenar region and investigate the anatomical basis for perforator propeller flaps for coverage of the flexor aspect of the little finger. The area between the pisiform and the base of the little finger was studied in 14 hands of fresh cadavers injected with red latex. An oval flap 1.5cm large was raised along the axis between these two points. Perforators going into the flap were dissected up to their origin from the ulnar palmar digital artery of the little finger, and their distance from the proximal edge of the A1 pulley was recorded. The mean number of perforator arteries entering the flap was 5.8 (range 4-8). A constant sizeable perforator was identified within 0.7cm from the proximal margin of the A1 pulley in all 14 specimens. In the majority of cases (64%), the most distal perforator was located at this level. Dissection of the flap was carried out suprafascially on the most distal perforator and 180° rotation allowed the flap to reach the flexor surface of the fifth finger. The donor site was closed primarily. Distal perforators of the ulnar palmar digital artery of the little finger are constantly found. Our anatomical findings support the possibility of raising a propeller perforator flap from the hypothenar region for coverage of the flexor aspect of the little finger. Its clinical application could provide a quick and straightforward single-stage option with a negligible donor-site morbidity for reconstruction of such defects.

Innervated Digital Artery Perforator Flap

To describe a technique for covering defects of the fingertips: the innervated digital artery perforator (IDAP) flap. A total of 17 patients were treated with an IDAP flap. The size of the flaps varied between 2 ×1 cm and 3.5 × 2 cm. Postoperative evaluation of the patients consisted of the Semmes-Weinstein Monofilament test, static 2-point discrimination, patient satisfaction, extension loss, and an investigation into complications. All IDAP flaps survived completely, and no patients required secondary interventions. The mean follow-up period was 7 months (range, 6-10 mo). The Semmes-Weinstein monofilament test results ranged from 3.22 to 3.84. The static 2-point discrimination in the flaps ranged from 2 mm to 4 mm (mean, 3.4 mm) compared with a range of 2 mm to 3 mm (mean, 2.7 mm) on the contralateral hand. There were no joint contractures in the reconstructed fingertips, although 2 patients developed mild hook nail deformity. One patient experienced mild cold intolerance, and 1 patient exhibited mild postoperative hypersensitivity. The advantages of the IDAP flap include minimally invasive surgery; a reliable, versatile flap; and the ease of the technique for different-sized fingertip defect reconstructions with few complications. The IDAP flap may be useful in fingertip amputations when the amputated part is not suitable for replantation. Therapeutic IV.

Repair of fingertip defects with lateral flaps of finger based on digital artery perforator

Objective To analysis the clinical efficacy of using lateral homodigital flaps based on digital artery perforator to repair the fingertip defects. Methods From October 2008 to August 2010,nine patients with twelve fingertip defects,including 5 thumbs,2 index fingers,3 middle fingers,2 ring fingers,underwent repair with lateral homodigital flaps based on digital artery perforator.The size of the flaps ranged from 2.7 cm× 1.4 cm to 3.1 cm× 1.8 cm.The donor site were covered by skin graft. Results Eleven flaps survived.One case met with partial necrosis.The follow-up time ranged from 3 to 6 months(average of 4.5 months).The finges had good appearance.Ten cases had gained full postoperative sensory recovery and the two-point discrimination was 4-Smm at 3 months after operation.Conclusion Using the flaps pedicled with digital artery perforator is a feasible solution for treatment of fingertip defects. Key words: Digital artery perforator flap ; Transplantation ; Finger; Injuries

DIGITAL ARTERY PERFORATOR FLAP FOR RECONSTRUCTION OF FINGERTIP AFTER RESECTION OF MELANOMA IN SITU

A case of 40-year-old female with melanoma in situ on her left index finger is presented. When treating melanoma in situ, it is recommended to have 3 mm margin and to include subcutaneous fat layer for resection of the tumor. To reconstruct the fingertip with the exposed distal phalanx, we used digital artery perforator flap. Since the resection of melanoma in situ in the appropriate manner would result in low risk of recurrence of the tumor, unlike melanoma of more deeply infiltrating types, it is important to use flaps which are easy to raise, functionally superior, and cosmetically excellent, The drawbacks of using digital artery perforator flap is that the operator is not able to tell if the flap includes the perforator until the flap is raised, since there is a risk of damaging the perforator when trying to expose it to visually confirm that it is included in the flap.

The ulnar digital artery perforator flap

The ulnar digital artery perforator flap

The ulnar digital artery perforator flap

The ulnar digital artery perforator flap

The ulnar digital artery perforator flap: A new flap for little finger reconstruction - A preliminary report

An ulnar digital artery perforator flap was used for little finger reconstruction. The flap has a reliable blood supply, being perfused by a constant sizeable perforator. This paper describes a study of a cadaveric dissection with methylene blue dye that was conducted to prove the rationality and reliability of the blood supply. The position of the perforator is confirmed intraoperatively by an exploratory incision before committing to the distal incision. The flap used to cover the flexor aspect of the little finger in three cases yielded positive results. To our knowledge, a digital artery perforator flap of this nature is unprecedented. We propose to call this flap the B.J. Flap after our institute.

Digital artery perforator (DAP) flaps: Modifications for fingertip and finger stump reconstruction

Various fingertip reconstructions have been reported for situations where microsurgical finger replantation is impossible. One method is the digital artery perforator (DAP) flap. Herein we report 13 DAP flaps for fingertip and finger stump reconstruction following traumatic finger amputations, highlighting modifications to the originally described DAP flap. From October 1998 to December 2007, a total of 13 fingers (11 patients) underwent fingertip and finger stump reconstruction with modified DAP flaps following traumatic finger amputations. We performed six adipocutaneous flaps, three adipose-only flaps, two supercharged flaps and two extended flaps. Flap size ranged from 1.44 to 8 cm(2) (average 3.25 cm(2)). All flaps survived completely with the exception of partial skin necrosis in two cases. One of these cases required debridement and skin grafting. Our initial three cases used donor-site skin grafting. The donor site was closed primarily in the 10 subsequent cases. No patients showed postoperative hypersensitivity of repaired fingertips. Semmes-Weinstein (SW) test result for flaps including a digital nerve branch did not differ from those without (average 4.07 vs. 3.92). Modified DAP flaps allow for preservation of digital length, volume and finger function. They can be raised as adiposal-only flaps or extended flaps and supercharged through perforator-to-perforator anastomoses. The donor defect on the lateral pulp can be closed primarily or by skin grafting. For traumatic fingertip and finger stump reconstructions, DAP flaps deliver consistent aesthetic and functional results.

Anatomical study of the perforators from the ulnar palmar digital artery of the little finger and clinical uses of digital artery perforator flaps

Our aim was to explore the anatomical features of the cutaneous perforators from the ulnar palmar digital artery of the little finger and to establish the anatomical basis of the ulnar palmar digital artery perforator flap for reconstruction of the ulnar aspect of the palm and fingers. We found that at least one perforator is present between the metacarpophalangeal (MCP) joint and 9 mm proximal to the MCP joint. This finding establishes the anatomical basis of the distal base ulnar palmar digital artery perforator flap for reconstruction of the ulnar aspect of the palm and fingers.

Digital Artery Perforator Flaps for Fingertip Reconstructions

Digital Artery Perforator Flaps for Fingertip Reconstructions