Reconstruction of Soft Tissue of the Finger Using Heterodigital Reverse Island Flap.

Abstract

Reconstruction of soft tissue defects of the fingers is still a challenge. Considering the special characteristics of finger skin, and the "like for like" principle, appropriate reconstruction should use local tissue as much as possible. Here, we introduce a reverse flow type of heterodigital island flap and evaluate the outcome of finger reconstruction using this technique. Thirty-two patients who underwent finger reconstruction using heterodigital reverse island flaps between August 2014 and March 2017 were included in this study. The study population consisted of 25 male and 7 female patients, with a mean age of 27.5 years (range, 6-67 years). The defect ranged from 1.5 to 2.5 cm in length and from 1.0 to 2.1 cm in width. All 32 flaps survived intact. After 1 year, the range of motion in the proximal interphalangeal joint was 81.0 ± 5.1, and the range of motion in the distal interphalangeal joint was 71.2 ± 5.7. The mean static 2-point discrimination of the flaps was 5.3 mm (range, 2-8 mm), and the donor finger was 9.2 mm (range, 4-9 mm), which is regarded as good to excellent, by the Modified American Society for Surgery of the Hand Guidelines. The mean visual analog scale (VAS) pain score was 2.5 (range, 0-8). The mean Vancouver Scar Scale (VSS) score of the flap was 3.95 (range, 1-11), and that of the donor site was 1.76 (range, 0-5). The mean follow-up period was 21.6 months (range, 12-36 months). Given its satisfactory esthetic and functional results, the heterodigital reverse island flap based on a long vascular pedicle in a reverse pattern is a feasible option for reconstruction of defects of the hand.