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Syndactylized glabrous flaps for multiple finger palmar defects.

Özgün Barış Güntürk1, Kubilay Erol1, Yusuf Gürbüz1

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Syndactylizing free glabrous flaps effectively cover multiple finger pulp defects, restoring function for patients. This technique offers good tissue coverage with minimal donor-site issues, though it involves complex surgery.

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Area of Science:

  • Plastic Surgery
  • Microsurgery
  • Hand Surgery

Background:

  • Palmar finger and pulp defects necessitate glabrous tissue coverage for optimal reconstruction.
  • Managing multiple finger defects presents challenges for local or pedicled flaps.
  • Syndactylizing free or pedicled flaps offers a solution for complex finger defects.

Purpose of the Study:

  • To evaluate the outcomes of syndactylized free glabrous flaps for multiple finger palmar or pulp defects.
  • To assess the functional results and patient-reported complaints after this reconstructive procedure.

Main Methods:

  • Seven syndactylized glabrous free flaps were employed to reconstruct defects in 16 fingers.
  • The study utilized superficial branch of the radial artery (SUPBRA) and hypothenar free flaps.
  • Functional outcomes and patient complaints were systematically assessed post-operatively.

Main Results:

  • Six out of seven flaps achieved successful survival.
  • Postoperative data from 13 fingers indicated all patients returned to their previous work.
  • Patients experienced diminished protective sensation (SWM test ≥ 4.31) with a mean two-point discrimination of 9.9 mm.

Conclusions:

  • Syndactylized glabrous flaps provide robust coverage for large finger defects with a low risk of contracture.
  • Advantages include a single operative site and adequate tissue volume.
  • Disadvantages involve complex, two-stage microsurgery and extended recovery periods.