Innervated dorsoradial perforator free flap: A reliable supermicrosurgery fingertip reconstruction technique

Publication date: Available online 27 May 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Dajiang Song, Georgios Pafitanis, Peng Yang, Mitsunaga Narushima, Zan Li, Linfeng Liu, Zengtao Wang
IntroductionThis study demonstrates the use of a modified free innervated DRAP flap utilizing the supermicrosurgery technique for fingertip reconstruction.Materials and MethodsFrom January 2010 to February 2014, 20 cases of fingertip reconstruction were performed using a short pedicle mini innervated transverse DRAP flap. The patients demographics, the mechanism of injury, the defect size and anatomical location, the source of pedicle vessels, the recipient vessels, the nerve branch used for innervation, the follow-up and sensation outcomes are reported. Three cases are presented demonstrating different anatomical fingertip injury reconstructions.Results20 consecutive traumatic fingertip injuries (M:F-14:6) were reconstructed with a free DRAP flap from the same hand. 6 index, 6 middle, 5 ring and 3 little finger defects were included in this study. All procedures were performed under regional anaesthesia and sedation. There were no intra- or post-operative complications. The average operative time was 105 (85-120) minutes. Each flap size was matching the size of the defects. All donor sites achieved primary closure and good cosmesis. The average follow-up was 12.8 (6-28) months. Follow-up demonstrated a static two-point discrimination of the flaps with an average distance of 5.5 (4-7) mm.ConclusionThe innervated DRAP flap has proven to be an easy, reliable and effective sensate fingertip reconstruction option, utilizing the supermicrosurgery technique.Level of EvidenceLevel IV, retrospective series.



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