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Analysis of thumb pulp reconstruction based on different local flaps: A systematic review
Jefferson Braga Silva1,2, Catarina Vellinho Busnello3, Amanda Gros3
1Service of Hand Surgery and Reconstructive Microsurgery, PUCRS University, Porto Alegre, Brazil.
Reconstructing thumb pulp involves various local flaps. This review compares outcomes of common flaps like the First Dorsal Metacarpal Artery (FDMCA) flap, aiding surgeon choice for better patient recovery.
Area of Science:
- Plastic Surgery
- Hand Surgery
- Reconstructive Surgery
Background:
- Thumb pulp reconstruction presents challenges due to varied flap outcomes and costs.
- No definitive consensus exists on the optimal local flap for thumb reconstruction.
Purpose of the Study:
- To analyze outcomes of commonly used local flaps for thumb volar substance trauma.
- To validate primary indications for different thumb reconstruction flaps.
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Searched MEDLINE/PubMed, VHL, Embase, and Scopus (last 10 years until April 2022).
- Screened 573 records, including 20 studies for analysis.
Main Results:
- Compared outcomes and prognostic factors for First Dorsal Metacarpal Artery (FDMCA), modified FDMCA (MFDMCA), Moberg, Heterodigital Neurovascular Island, Neurovascular Island Pedicle, and Modified Littler flaps.
- Identified MFDMCA, Moberg, Neurovascular Island pedicle, and FDMCA flaps as generally positive.
Conclusions:
- Multiple flaps are viable for thumb pulp reconstruction.
- Surgeons must consider prognostic factors impacting return to daily activities when selecting a flap.
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