One-stage reconstruction for amputated thumbs with melanoma

The reconstruction of amputated thumbs is difficult because of a poor prognosis, and the varying length and volume of the lost thumbs. Two patients underwent reconstruction of amputated thumbs in one stage with the use of a modified wrap-around flap procedure. An onychocutaneous flap from the big toe is suitable for partial defects, including the nail of the distal phalanx. A combined dorsalis pedis flap and wrap-around flap is also superior for total thumb reconstruction after amputation at the metacarpal phalanx involving the thenar region.