Coverage of Dorsal Tissue Loss of Long Fingers by a Adipofascial Pedunculated Flap

Abstract

Introduction: We report a series of dorsal adipofascial pedunculated cutaneous flaps of fingers used in retrograde or anterograde flow. Materials and Methods : This is a retrospective study realized into the plastic surgery department of the Nabeul University Hospital. Ten flaps were harvested  from 10 patients, whose the average age was  40 years,    predominantly male (8 men), all losses of substances were post-traumatic, coverage was       carried out secondarily in all cases. Four flaps had a retrograde pedicle and 6 anterograde one. The donor site of the flap was adjacent to the loss of substance in all cases, the                          loss of residual substance was covered by total skin grafting taken from the anterior face of          the wrist. Results: Temporary distal venous conestion  was noted in one case. No necrosis was observed. The quality of tissue coverage did not result in any functional discomfort and was considered satisfactory. Discussion: These flaps offer a great flexibility of use allowing to adapt as well to its localization and the size of the skin substance loss as to the trophic quality of the skin tissue surrounding it. The homodigital character of these flaps avoids the inconvenience encountered with flaps taken from the back of the hand or cross finger flaps. Conclusion: Due to their reliability related to the anastomotic character of their vascularization, these flaps constitute the treatment of choice of the medium-sized losses of distal dorsal tissue of the long fingers, (not exceeding 2,5 cm of long axis).