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Free toe pulp flap for finger pulp and volar defect reconstruction
1Department of Plastic Surgery, Sushrutha Institute of Plastic Reconstructive and Aesthetic Surgery, Elite Mission Hospital, Thrissur, Kerala, India.
Summary
Free toe pulp flaps offer an effective solution for fingertip reconstruction, providing good functional and aesthetic outcomes. This study highlights their utility in complex finger defect repairs.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Microsurgery
Background:
- Fingertip injuries are common and necessitate flap coverage for optimal functional and aesthetic results.
- The ideal reconstructive method balances restoration of form and function.
Purpose of the Study:
- To evaluate the efficacy of free toe pulp flaps in reconstructing fingertip and volar finger defects.
- To assess both functional and aesthetic outcomes following this reconstructive procedure.
Main Methods:
- Seven free toe pulp flaps were performed for finger defect reconstruction between June 2015 and April 2016.
- Flaps utilized great toe lateral pulp for thumb reconstruction and second toe pulp for other digits.
- Follow-up included functional assessments (two-point discrimination, sensation) and aesthetic evaluation.
Main Results:
- Five flaps achieved complete survival, one had partial loss, and one failed.
- Median follow-up was 9 months; median surgery duration was 255 minutes.
- Good sensory recovery (two-point discrimination median 6.5 mm) was observed, though two patients experienced cold intolerance. Three patients had delayed donor site healing.
Conclusions:
- Free toe pulp flaps are an efficient reconstructive option for fingertip and volar finger defects.
- The procedure offers an excellent tissue match, contributing to successful functional and aesthetic restoration.
