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CC BY-NC 4.0 · Arch Plast Surg 2012; 39(05): 546-550
DOI: 10.5999/aps.2012.39.5.546
Original Article

Fingertip Reconstruction Using Free Toe Tissue Transfer Without Venous Anastomosis

Won Young Yoon
Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea
,
Byung Il Lee
Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea
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Background This study was designed to introduce the feasibility of toe tissue transfer without venous outflow for fingertip reconstruction.

Methods Five cases of fingertip defects were treated successfully with this method. Four cases were traumatic fingertip defects, and one case was a hook-nail deformity. The lateral pulp of a great toe or medioinferior portion of a second toe was used as the donor site. An arterial pedicle was dissected only within the digit and anastomosis was performed within 2 cm around the defect margin. The digital nerve was repaired simultaneously. No additional dissection of the dorsal or volar pulp vein was performed in either the donor or recipient sites. Other surgical procedures were performed following conventional techniques. Postoperative venous congestion was monitored with pulp temperature, color, and degree of tissue oxygen saturation. Venous congestion was decompressed with a needle-puncture method intermittently, but did not require continuous external bleeding for salvage.

Results Venous congestion was observed in all the flaps, but improved within 3 or 4 days postoperatively. The flap size was from 1.5×1.5 cm2 to 2.0×3.0 cm2. The mean surgical time was 2 hours and 20 minutes. A needle puncture was carried out every 2 hours during the first postoperative day, and then every 4 hours thereafter. The amount of blood loss during each puncture procedure was less than 0.2 mL. In the long-term follow-up, no flap atrophy was observed.

Conclusions When used properly, the free toe tissue transfer without venous anastomosis method can be a treatment option for small defects on the fingertip area.

Keywords

Finger injuries - Free tissue flaps - Hyperemia

This article was presented the 11th Triennial Congress of the International Federation of Societies for Surgery of the Hand on November 4, 2010 in Seoul, Korea.




Publication History

Received: 03 May 2012

Accepted: 08 August 2012

Article published online:
01 May 2022

© 2012. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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