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Another new attempt to repair finger pulp defects: retrograde island flap bridge transfer of the adjacent phalangeal artery combined with vascular pedicle tubular skin grafting
Authors:Weibin Du  Fangbing Zhu  HeLou Zhang  Jun Yang  Wei Zhuang  Qiao Hou
Affiliation:1.Research Institute of Orthopedics, the Affiliated Jiangnan Hospital of Zhejiang Chinese Medical University, Hangzhou, 312001, China; 2.Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine, Hangzhou, 312001, China; 3.Zhejiang Chinese Medical University, Hangzhou, 310053, China
Abstract:This study investigated the surgical method and therapeutic effect of retrograde island flap bridge transfer of the adjacent phalangeal artery combined with vascular pedicle tubular skin grafting to repair finger pulp defects. From June 2008 to May 2020, 21 fingers (19 patients) were repaired using this method. The postoperative flap survival rate and complications, and the clinical effect, were evaluated. All flaps survived, and all patients were followed-up for 12 to 46 months. The static two-point discrimination (2PD) was 7 to 11 mm, no apparent complications were observed in the donor area and the McIndoe cold intolerance symptom severity (CISS) scores indicated mild severity. The Michigan hand outcome questionnaire (MHQ) indicated that all patients were satisfied with their overall hand appearance and function. Results were excellent in 15 cases and good in 4 cases, according to the Dargan function evaluation (DFE). It is safe and effective to repair finger pulp defects with a retrograde island flap bridge transfer of the adjacent phalangeal artery combined with vascular pedicle tubular skin grafting. This skin flap has the advantages of simple severing, good texture and concealed donor area, which is convenient for early postoperative functional exercise of the finger.
Keywords:Adjacent finger   retrograde island flap   bridge transfer   vascular pedicle   finger pulp defect   postoperative outcome   aesthetics
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