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[Transfer of neurovascular island flap from the same finger for repairing pulp defect]
Lirong Zhou1, Wei Wang, Jun Li
1Hand and Microsurgery Center, Bao Shan Branch of Shanghai No 1 Affiliated Hospital, Shanghai Jiaotong University, PR China. guang1934@hotmail.com
Objective:
To observe the clinical effects of neurovascular island flap from the same finger for repairing pulp defect.
Methods:
From November 2003 to February 2005, 32 pulp defects in 30 cases were covered with neurovascular island flap from the same finger. There were 25 males and 5 females. The age ranged from 18 to 56 years. The operation was performed after debridement and 2-8 days antibiotics therapy. The defect area ranged from 1.5 cm x 1.2 cm to 3.5 cm x 2.1 cm. The flap was harvested on the dorsal part of the finger ulnarly or radially. The distal end of the flap should be more than 5 mm away from the nail base to avoid nail injury. The ventral and dorsal cut should not exceed the middle line respectively. The flap size ranged from 2.0 cm x 1.5 cm to 4.0 cm x 2.5 cm. The donor site was covered with flap of subdermal vascular plexus from the medial side of the upper arm.
Results:
All 32 transferred flaps survived after operation. There was no vascular crisis. Twenty-five cases were followed up from 2 to 8 months. The flaps had good appearance and texture and blood circulation. Two-point discrimination was 7-10 mm. The function of finger motion was returned to normal.
Conclusion:
Transfer of neurovascular island flap from the same finger offered a sensational skin flap for reconstruction of pulp defect. The technique was simple, and the clinical result was satisfactory. It is an ideal method for reconstruction of thumb or finger pulp defects.
