Innervated Digital Artery Perforator Flap: A Versatile Technique for Fingertip Reconstruction

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Microsurgery

Background:

• Fingertip injuries are common and present significant reconstructive challenges.
• Innervated digital artery perforator (IDAP) flaps offer a potential solution for restoring sensation and function.

Purpose of the Study:

• To evaluate the efficacy and outcomes of using IDAP flaps for fingertip and finger stump reconstruction.
• To demonstrate the advanced application of IDAP flaps in a clinical setting.

Main Methods:

• A retrospective study of 65 fingers (59 patients) reconstructed with IDAP flaps between August 2011 and May 2014.
• Objective outcomes included static 2-point discrimination, Semmes Weinstein monofilament tests, and extension loss.
• Subjective outcomes assessed hypersensitivity, cold intolerance, and patient satisfaction.

Main Results:

• All 61 evaluated IDAP flaps (mean follow-up 18 months) survived without secondary intervention.
• Good sensory recovery was noted (mean 2-point discrimination 3.5 mm), though slightly less than contralateral hands.
• Minor issues like mild extension loss, cold intolerance, and hypersensitivity were reported in a small number of patients.

Conclusions:

• IDAP flaps are a sensitive, reliable, and versatile option for acute fingertip reconstruction.
• These flaps can also be considered for revising previously reconstructed defects.
• The study supports the advanced use of IDAP flaps in reconstructive surgery.