The free instep flap for palmar and digital resurfacing

Area of Science:

• Microsurgery
• Plastic Surgery
• Regenerative Medicine

Background:

• Palmar and digital volar skin defects pose reconstructive challenges due to unique skin characteristics.
• Existing skin flaps often result in color and texture mismatches, compromising aesthetic outcomes.
• Homodigital or thenar flaps may not be suitable for all palmar defects.

Purpose of the Study:

• To evaluate the efficacy of the free instep flap for palmar and volar digital resurfacing.
• To present a refined technique for raising the free instep flap.
• To explore the potential for neurotization with the free instep flap.

Main Methods:

• Description of a refined free instep flap harvesting technique.
• Discussion of potential neurotization strategies for enhanced sensation.
• Comparative analysis with conventional pedicled and free flaps for palmar resurfacing.

Main Results:

• The free instep flap provides glabrous, hairless skin suitable for palmar and digital reconstruction.
• This flap offers a superior color and texture match compared to conventional methods.
• The technique allows for potentially sensate reconstruction, improving functional outcomes.

Conclusions:

• The free instep flap is an appropriate choice for palmar and volar digital resurfacing.
• It offers a cosmetically superior option for reconstructive surgery.
• Refined techniques and neurotization enhance its role in idealized resurfacing.