Reconstruction of Multiple-Finger Soft-Tissue Defects Using Dorsal Homo/Heterodigital Flaps: Results from a Single-Centre Cohort

Chao Chen1#, Xinzhong Shao2#, Xu Zhang2, Yingnan Liu1, Ruihong Wei1, Yongqing Zhuang1* and Yali Xu2*

1Department of Hand Surgery, Shenzhen People's Hospital, Second Clinical Medicine College of Jinan University, First Affiliated Hospital of Southern University of Science and Technology, China
2Department of Hand Surgery, Third Hospital of Hebei Medical University, China
#These authors contributed equally to this work

^*Correspondance to: Yali Xu 

 PDF  Full Text DOI: 10.25107/2474-1647.3393

Abstract

Background: Reconstruction of soft-tissue defects in multiple fingers poses a significant challenge. This article reports simultaneous repair of multiple small-to-moderate soft-tissue defects using two types of island flaps harvested from the dorsum of the fingers and evaluates the efficacy of their application in such complex situation. Methods: Over 10 years, a retrospective study was conducted with 26 patients who had multiplefinger soft-tissue defects treated with dorsal homo/hetero digital island flaps. There were 64 softtissue defects in 64 fingers. The injured fingers included 14 index, 21 long, 20 ring, and nine little fingers. The mean size of soft-tissue defects and flaps was 2.4 ± 0.1 × 1.8 ± 0.1 cm and 2.6 ± 0.1 cm × 1.9 ± 0.1 cm respectively. Soft-tissue defect was reconstructed with the fascia-cutaneous island flap in 43 fingers and the neurocutaneous island flap in 21 fingers, respectively. Results: Full flap survival was achieved in 58 fingers. Partial distal flap necrosis was noted in six fingers, which healed without surgical intervention. We evaluated flap sensibility in 36 fingers where sensory return was considered important. The sensate island flaps achieved better discriminatory sensation than non-sensate flaps. According to the Michigan Hand Outcomes Questionnaire, 10 patients were strongly satisfied and 11 were satisfied and five were neither satisfied nor dissatisfied with functional recovery of the reconstructed fingers. Conclusion: A combined use of dorsal homo/hetero digital island flaps is reliable and technically easy for simultaneous reconstruction of small-to-moderate soft-tissue defects in multiple fingers.

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Cite the article

Chen C, Shao X, Zhang X, Liu Y, Wei R, Zhuang Y, et al. Reconstruction of Multiple-Finger Soft-Tissue Defects Using Dorsal Homo/Heterodigital Flaps: Results from a Single-Centre Cohort. Clin Surg. 2022; 7: 3393..