Heterodigital Free Flap of Index Finger Amputee for Coverage of the Long Finger Soft Tissue Defect
Patient presented with serious crushing injury to fingers, the index finger structure was so badly damaged that replantation of the same digit was contraindicated, as no function would be regained. Therefore, a 5x3 cm flap of the finger, including a digital artery and a dorsal subcutaneous vein were dissected and used as coverage of the extensor digitorum tendon, which had become exposed on the middle finger. This was all done after the bone had been removed from the amputated structure. The flap was initially attached by partial sutra, the artery and vein reconnection was done under microscope and excellent blood flow was observed immediately. The rest of the flap was sutured and all reconstructed tissue showed full survival.
10 days post surgery patient began active and passive movement exercises, ensuring joint recovery. In the 6 months follow up patient showed recovery of full function of the middle finger with no report of pain. This process is referred to as heterodigital replantation and has the advantage of minimizing scars, enabling early primary healing and no complications at the site from which the flap was taken. However, it is noted as important to perform proper removal of dead or dying cells of the flap tissue used. > From: Hwang et al., Arch Reconstr Microsurg 22 (2013) 82-85. All rights reserved to the Korean Society for Microsurgery.
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