Clinical application of retrograde perforator flap relay for repair of soft tissue defects at the fingertips
Objective To discuss the clinical efficacy of relay retrograde perforator flaps for repairing soft tissue defects at the fingertips and wounds in the dorsal finger donor area.Methods From March 2020 to August 2022,7 patients with soft tissue defects at the distal end of the fingers were treated in our hospital.The reverse island skin flap with the perforator of the digital artery was used to repair the defect wound.The donor area of the flap was repaired with a relay flap pedicled with the perforator of the dorsal metacarpal artery web.The skin flap was cut with an area of 1.5 cm×2.0 cm to 2.0 cm×3.0 cm.After the flap was cut,it was transferred through a subcutaneous tunnel or open channel to cover the recipient area,and the dorsal or volar flap donor site was directly sutured.Results All flaps of 7 cases(7 fingers)survived after surgery.The follow-up period was 3 to 13 months,with an average of 8 months.The skin flap had good appearance and elasticity,no significant difference in skin color and texture compared to the healthy side,no swelling in appearance,satisfactory finger movement function,and no tendon adhesion or joint stiffness.The two-point discrimination of the flap was 7 to 10 mm,with an average of 8 mm.The hand function was evaluated based on total active motion(TAM).The result was excellent in 6 cases and good in 1 case.The patient was satisfied with the appearance and function of the injured finger.Conclusion The reverse island skin flap with the perforator of the digital artery skin is used to repair the defect wound.The relay skin flap with the perforator of the dorsal metacarpal artery finger web as the pedicle is used in the flap donor site for repair,which is simple in operation,does not sacrifice the main blood vessels,and takes into account durability and aesthetics.The donor site can be directly sutured,and the clinical efficacy is satisfactory.
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