[Repair of the finger proximal and middle segment soft tissue defect with flap transplantation]

To summarize and analyze the surgical methods and therapeutic effects of repair of the finger proximal and middle segment soft tissue defect with three different types of skin flaps.

From May 2011 to May 2015, 102 patients with 115 fingers proximal and middle segment soft tissue defect underwent reconstruction with three different types of skin flaps. There were 59 males with 70 fingers and 43 females with 45 fingers, aged from 19 to 62 years old with an average of 45.6 years. Twenty-nine patients with 29 fingers were repaired by free peroneal artery perforator flaps, 35 patients with 37 fingers were repaired by the free vascularized flaps based on the wrist cutaneous branch of ulnar artery, 38 patients with 49 fingers were repaired by metacarpal dorsal artery perforator flaps. The soft tissue defect area varied from 1.8 cm×4.0 cm to 2.8 cm×5.4 cm. The flap area varied from 2.0 cm×4.4 cm to 3.1 cm×6.0 cm. The clinical results were evaluated based on flap survival rate, finger function and complications.

All flaps survived. Distal skin flap necrosis occurred in 5 flaps, but healed after wound dressing therapy. No deep infection were found in donor site and recipient site. There were 3 cases with partial necrosis of the skin graft, and delayed healing after wound dressing therapy. All patients were followed up from 6 to 28 months with an average of 10.6 months. The appearance and texture of flaps were well. The sensation were good, two-point discrimination was 9 to 13 mm. There were no obvious dysfunction happened in the donor site. The function of the fingers was excellent in 52 cases, good in 41, fair in 9 cases.

About the repair of the finger proximal and middle segment soft tissue defect, the right flap should be choosen based on the difference of the sex and the age in patients, wounds situation, the master degree of the operation method and the hospital's technical conditions.