Cosmetic reconstruction of the digits in the hand by composite tissue grafting

This article presents the authors' methods of digital reconstruction using composite tissue transfer. The authors present their approach to achieve restoration of full cosmetic appearance of the reconstructed thumbs or fingers while preserving the function and cosmetic appearance of the donor foot. The reconstructive procedures for each degree of digit defect are discussed in detail, and pitfalls and technical tips are given. This article summarizes the authors' experience in reconstruction of 646 digits since 1998 and the challenges that they faced in the complex microsurgical reconstruction necessary to pursue the goal of restoring the cosmetic appearance of reconstructed digits and donor feet.