Innervated Local Flap Reconstruction for Digital Soft Tissue Defects: A Systematic Review

Area of Science:

• Plastic Surgery
• Hand Surgery
• Regenerative Medicine

Background:

• Restoring tactile sensation is vital for optimal hand function after fingertip injuries.
• Digital soft tissue defects often require reconstructive surgery.
• The choice between innervated and non-innervated flaps impacts sensory recovery.

Purpose of the Study:

• To systematically review and compare the sensory outcomes of innervated flaps (IF) versus non-innervated local flaps (NIF) in fingertip reconstruction.
• To evaluate the effectiveness of neurorrhaphy in improving sensory results for digital soft tissue defects.

Main Methods:

• Systematic literature search of PubMed, MEDLINE, Cochrane, and EMBASE databases.
• Inclusion of English-language studies reporting sensibility outcomes in fingertip reconstruction.
• Analysis of data from 11 studies encompassing 591 flaps published between 1983 and 2023.

Main Results:

• Innervated flaps (IF) demonstrated significantly superior sensibility outcomes compared to non-innervated local flaps (NIF).
• The data suggests a positive correlation between the inclusion of neurorrhaphy and improved sensory recovery in reconstructed fingertips.

Conclusions:

• Innervated local flaps are recommended for fingertip reconstruction to achieve better tactile sensation.
• Performing neurorrhaphy during local flap reconstruction is advised to enhance sensory outcomes in digital soft tissue defects.