Related Experiment Videos
Donor site morbidity in cross-finger flaps
H Koch1, A Kielnhofer, M Hubmer
1Division of Plastic Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29, A-8036 Graz, Austria. horst.koch@meduni-graz.at
British Journal of Plastic Surgery
|July 26, 2005
Summary
Cross-finger flaps are valuable for finger reconstruction but cause significant donor site morbidity. Full-thickness skin grafts offer better cosmetic results and reduced complications compared to split-thickness grafts for donor site closure.
Area of Science:
- Hand Surgery
- Plastic Surgery
- Reconstructive Surgery
Background:
- Cross-finger flaps are a reconstructive option for finger defects.
- Limited literature exists on donor site morbidity associated with cross-finger flaps.
- Donor site complications can impact patient outcomes and functional recovery.
Purpose of the Study:
- To assess donor site morbidity following cross-finger flap reconstruction.
- To compare outcomes between split-thickness and full-thickness skin grafts for donor site closure.
- To evaluate functional and subjective outcomes, including range of motion, grip strength, pain, and cosmesis.
Main Methods:
- Prospective study of 23 patients undergoing cross-finger flap reconstruction.
- Exclusion of patients with additional trauma to the donor finger.
- Donor site closure utilized split-thickness skin grafts (13 patients) or full-thickness skin grafts (10 patients).
- Assessment included range of motion, grip strength, scar evaluation, pain (visual analogue scale), cold intolerance, and cosmetic appearance.
- Follow-up averaged 83 months, with comparisons to the contralateral hand.
Main Results:
- Donor fingers showed significantly reduced active total range of motion (156° vs. 173.6°, p=0.03) and grip strength (p=0.03) compared to controls.
- No significant difference in range of motion or grip strength was found between split-thickness and full-thickness graft sites (p=0.91).
- Full-thickness grafts resulted in significantly better subjective cosmetic outcomes.
- Donor finger pain averaged 2.4 (range 0-8). Cold intolerance was reported by 5/13 split-thickness and 2/10 full-thickness graft patients.
Conclusions:
- Cross-finger flaps are a reliable method for finger reconstruction.
- Significant donor site morbidity, including reduced range of motion and grip strength, is associated with cross-finger flaps.
- Full-thickness skin grafts are recommended for donor site closure due to superior cosmetic results and potentially lower complication rates.