Fingertip reconstruction using free toe tissue transfer without venous anastomosis

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Microsurgery

Background:

• Investigating the feasibility of toe tissue transfer for fingertip reconstruction without venous outflow.
• Addressing the need for innovative reconstructive techniques for fingertip defects.

Purpose of the Study:

• To evaluate the efficacy and safety of free toe tissue transfer without venous anastomosis for fingertip reconstruction.
• To present a novel surgical approach for small fingertip defects.

Main Methods:

• Five cases of fingertip defects (four traumatic, one hook-nail deformity) were treated using toe tissue transfer.
• Arterial pedicle dissection was limited to the digit, with anastomosis near the defect margin.
• Digital nerve repair was performed concurrently; no additional venous dissection was required.
• Postoperative venous congestion was managed with intermittent needle-puncture decompression.

Main Results:

• All flaps showed initial venous congestion that resolved within 3-4 days.
• Flap sizes ranged from 1.5x1.5 cm² to 2.0x3.0 cm².
• Mean surgical time was 2 hours 20 minutes; minimal blood loss occurred during decompression.
• No flap atrophy was observed during long-term follow-up.

Conclusions:

• Free toe tissue transfer without venous anastomosis is a viable treatment option for select fingertip defects.
• The technique offers a potential solution for reconstructive challenges where traditional methods may be less suitable.
• Proper application of this method can lead to successful functional and aesthetic outcomes.