Predictable Pattern Digital Artery Perforator Flap: An Alternative Concept in Digital Reconstruction.

Area of Science:

• Microsurgery
• Plastic Surgery
• Hand Surgery

Background:

• Digital arteries provide cutaneous perforators vital for digit vascularization.
• The vasculo-cutano-tendino-osseous complex (VCTOC) is key to digital structure vascularization.
• Doppler flowmetry aids in identifying digital artery perforators.

Purpose of the Study:

• To demonstrate the in-vivo predictability of digital artery perforator (DAP) flaps.
• To evaluate the clinical application of predictable pattern digital artery perforator (PPDAP) flaps for digital reconstructions.
• To assess flap viability and digital function after PPDAP reconstruction.

Main Methods:

• Fifteen patients underwent reconstruction using PPDAP flaps for digital defects post-tumor extirpation.
• Flaps were designed as V-Y advancement or propeller types.
• Postoperative assessment focused on flap survival and digital function.

Main Results:

• All PPDAP flaps survived without venous congestion in seven males and eight females.
• Reconstructions addressed digital defects ranging from 0.5 to 1.5 cm.
• No functional digital issues were noted during a mean follow-up of 77 months, with one case of minor wound dehiscence.

Conclusions:

• The concept of a "predictable pattern" for digital perforator flaps was introduced.
• PPDAP flaps are reliable and represent a valuable reconstructive choice for digital defects.
• This technique facilitates predictable digital artery perforator flap harvest.