Abstract:
BACKGROUND:The dorsal metacarpal artery perforator flap is a versatile solution for resurfacing soft-tissue defects of fingers. The authors present their experience in applying this flap for a variety of finger wounds for which conventional means may not be amenable. METHODS:Fifty-eight dorsal metacarpal artery perforator flaps were used to resurface 60 finger soft-tissue defects in 56 patients over a 5-year period. Fifty-two patients were men and their average age was 37 years. This flap was used to reconstruct soft-tissue defects after débridement of infected wounds in 28 patients, traumatic wounds in 26 patients, and electrical burns in two patients. RESULTS:The average flap size was 4.6 × 2.3 cm; 34 flaps were based on the second dorsal metacarpal artery perforator, 14 were based on the third dorsal metacarpal artery perforator, and 10 were based on the fourth dorsal metacarpal artery perforator. Twenty-one flaps were used to resurface defects distal to the proximal interphalangeal joint, and 37 flaps were used to resurface defects over the proximal interphalangeal joint and proximal to it. Skin grafting was needed to close the donor defect in seven patients. Complications included venous congestion in six flaps and arterial insufficiency in three flaps, with total loss of two flaps and infection in one case. CONCLUSION:The dorsal metacarpal artery perforator flap is a thin, pliable flap that is simple to raise, has minimal donor-site morbidity, and can reliably cover soft-tissue defects up to the proximal half of the middle phalanx. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, IV.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Sebastin SJ,Mendoza RT,Chong AKS,Peng YP,Ono S,Chung KC,Lim AYTdoi
10.1097/PRS.0b013e318221ddfasubject
Has Abstractpub_date
2011-09-01 00:00:00pages
166e-178eissue
3eissn
0032-1052issn
1529-4242pii
00006534-201109000-00020journal_volume
128pub_type
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journal_title:Plastic and reconstructive surgery
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