Cross Finger Flap with Reduction Pulp Plasty and Full Thickness Skin Graft

수질부 축소술과 전층 피부이식술을 이용한 교차수지 피판술

  • Cho, Yong Hyun (Department of Plastic and Reconstructive Surgery, Medical School & Research Institute of Clinical Medicine, Chonbuk National University) ;
  • Roh, Si Gyun (Department of Plastic and Reconstructive Surgery, Medical School & Research Institute of Clinical Medicine, Chonbuk National University) ;
  • Lee, Nae Ho (Department of Plastic and Reconstructive Surgery, Medical School & Research Institute of Clinical Medicine, Chonbuk National University) ;
  • Yang, Kyung Moo (Department of Plastic and Reconstructive Surgery, Medical School & Research Institute of Clinical Medicine, Chonbuk National University)
  • 조용현 (전북대학교 의학전문대학원 성형외과학교실 전북대학교 임상의학연구소) ;
  • 노시균 (전북대학교 의학전문대학원 성형외과학교실 전북대학교 임상의학연구소) ;
  • 이내호 (전북대학교 의학전문대학원 성형외과학교실 전북대학교 임상의학연구소) ;
  • 양경무 (전북대학교 의학전문대학원 성형외과학교실 전북대학교 임상의학연구소)
  • Published : 2009.09.15

Abstract

Purpose: Typical cross finger flap is still a good method for reconstruction of fingertip injuries. However, it is necessarily followed by great loss and aesthetically unpreferable result of donor finger. Hereby, we introduce a modification of cross finger flap with reduction pulp plasty and full thickness skin graft, with which we could reduce the defect size of injured fingertip and donor site morbidity at the same time, without any need for harvesting additional skin from other part of hand. Method: This method was performed in the patients with fingertip injuries of complete amputation or in case of loss of fingertip due to necrosis after replantation. Firstly, reduction pulp plasty was performed on the injured finger to reduce the size of defect of fingertip. Additional skin flap was obtained from the pulp plasty. Secondly, cross finger flap was elevated from the adjacent finger to cover the defect on the injured finger. At the same time, defect on the donor finger produced by the flap elevation was covered by full thickness skin graft with the skin obtained from the pulp plasty of injured finger. Results: Flap and graft survived without any necrosis after surgical delay and flap detachment. All of them were healed well and did not present any severe adversary symptoms. Conclusion: Cross finger flap with reduction pulp plasty and full thickness skin graft is an effective method that we can easily apply in reconstruction of fingertip injury. We think that it is more helpful than the usual manner, especially in cases of children with less soft tissue on their fingers for preservation and reduction of the morbidity of donor finger.

Keywords

Acknowledgement

Supported by : 전북대학교병원

References

  1. Gurdin M, Pangman WJ: The repair of surface defects of trans-digital flaps. Plast Reconstr Surg 5: 368, 1950 https://doi.org/10.1097/00006534-195004000-00011
  2. Zook EG, Guy RJ, Russell RC: A study of nail bed injuries: causes, treatment, and prognosis. J Hand Surg Am 9: 247, 1984 https://doi.org/10.1016/S0363-5023(84)80153-7
  3. Brown RE, Zook EG, Russell RC: Fingertip reconstruction with flaps and nail bed grafts. J Hand Surg Am 24: 345, 1999 https://doi.org/10.1053/jhsu.1999.0345
  4. Paterson P, Titley OG, Nancarrow JD: Donor finger morbidity in cross-finger flaps. Injury 31: 215, 2000 https://doi.org/10.1016/S0020-1383(99)00205-3
  5. Kim CK, Kim JW, Lee SG, Kim YW, Chung CI, Whang S: Cross finger flap for finger pulp and stump reconstruction. J Korean Soc Surg Hand 4: 271, 1999