Free dorsoulnar perforator flap transfers for the reconstruction of severely injured digits

The aim of this study was to investigate the feasibility of transferring the free dorsoulnar perforator flap nourished by the cutaneous perforator branched dorsoulnar artery to reconstruct severely injured fingers under upper arm anesthesia. Between April of 2001 and April of 2002, 13 free dorsoulna...

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Bibliographic Details
Published in:	Plastic and reconstructive surgery (1963) Vol. 114; no. 2; pp. 411 - 420
Main Authors:	INADA, Yuji, TAMAI, Susum, KAWANISHI, Kouichi, OMOKAWA, Syouhei, AKAHANE, Manabu, SHIMOBAYASHI, Mikio, TSURUZONO, Masashi, TAKAKURA, Yoshinobu, INADA, Michio
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD Lippincott Williams & Wilkins 01-08-2004
Subjects:	Adolescent Adult Amputation, Traumatic - diagnostic imaging Amputation, Traumatic - surgery Anesthesia, Conduction Angiography Biological and medical sciences Cicatrix - surgery Female Finger Injuries - surgery Fingers - blood supply Humans Ischemia - diagnostic imaging Ischemia - surgery Male Medical sciences Microsurgery - methods Middle Aged Postoperative Complications - diagnostic imaging Postoperative Complications - surgery Reoperation Replantation - methods Soft Tissue Injuries - diagnostic imaging Soft Tissue Injuries - surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgical Flaps - blood supply Thermography Thumb - blood supply Thumb - injuries Thumb - surgery Ulnar Artery - diagnostic imaging Ulnar Artery - surgery Human Forearm Treatment Surgery Finger Free flap Transfer Anatomical reconstruction Technique
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Summary:	The aim of this study was to investigate the feasibility of transferring the free dorsoulnar perforator flap nourished by the cutaneous perforator branched dorsoulnar artery to reconstruct severely injured fingers under upper arm anesthesia. Between April of 2001 and April of 2002, 13 free dorsoulnar perforator flaps were used in 13 patients. There were 11 men and two women ranging in age from 18 to 64 years, with an average age of 38 years. The affected fingers were one thumb, four index fingers, five middle fingers, two ring fingers, and one little finger. All cases were performed under upper arm anesthesia combined with intravenous local anesthesia. The operative time ranged from 103 to 140 minutes, with an average time of 120 minutes. The flap size ranged from 1 x 3 to 3 x 4 cm, and was transferred from the same forearm of the injured finger. All donor sites were closed primarily without a skin graft. The aim of reconstruction for fingers was to repair a traumatic defect (five cases), partial necrosis following replantation (two cases), and soft-tissue defects resulting from resection of a scar (three cases) and to revascularize ischemic fingers (three cases). All flaps survived completely. After repair of the flow-through circulation of the common digital artery and ischemic finger, a postoperative angiogram showed the vascular patency and hypervascularity of the reconstructed fingers, and the patients' complaints were reduced. The free dorsoulnar perforator flap under regional anesthesia is first reported; it may become one valuable option as a very small flap for the treatment of repairing intercalated or segmental defects as a flow-through flap for soft-tissue defects and ischemic fingers.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0032-1052 1529-4242
DOI:	10.1097/01.prs.0000131881.42438.93