Repair of minor tissue defect in hand by transfer of free tissue flap from the Toe

To introduce our experience of using the free neurovascular flap from great and second toe. Thirteen patients [fifteen fingers] sought surgical treatment for soft tissue defects of the hand at our medical institutin between March 2006 and September 2009. In two patients, fibular side skin-nail flaps of great toe were applied to cover the dorsal defect of distal thumb. In twelve, in the treatment of pulp defect of finger with fibular side flap of great toe or tibial side flap of second toe. In one, in the treatment of defect of distal middle with composite flap with distal digital bone of second toe. All flaps were survived. The average subjective satisfaction score was 8.08 [range 4-10]. Nine patients [69%] experienced cold intolerance, and 2 patients [15%] dysesthesia. The Semmes-Weinstein sensitivity score was between 3.47and 4.72 on the flap, and 0-4.18 on the donor site. The mean two-point discrimination was 6.8mm [range 4-12]. Grip strength was 10% less than in the unaffected hand. The proximal interphalangeal mobility loss was less than 15 degrees. Our results indicated that these free flaps from toe are useful for patients with a small soft-tissue defect in hand

Reconstruction and repairation of partial thumb and finger defects with toe tissue transplantation / 中华显微外科杂志

Objective To investigate the therapeutic effect of toe transfer in reconstruction and repairation of thumb and finger defcts. Methods From December of 1996 to September of 2010,thirty-five partial thumb and finger defcts in 33 cases were treated with toe tissue for reconstructing and repairing.The transfer indication,surgery procedure,operative technique and treatment effect were retrospectively analyzed.Simultaneously how to improve the outcoming and success rate were explored and investigated.Results All 35 toe tissue were alive with aesthetic appearance and finefunction.Followed-up from 3 months to 12 years,and judged by the tentative evalution standard of function of upper limb,which was made by Chinese Medical Association for Surgery of the Hand.The results were excellent in 14,good in 16,fair in 3 and poor in 1.The rate of excellence and good was 85.7%. Conclusion Toe tissue transplantation is an ideal treatment for reconstructing and repairing partial thumb and finger defcts.

Reconstruction by the second toe tibial toe pulp skin flap for soft tissue defects of the finger / 中华显微外科杂志

Objective To discuss the surgery procedure and treatment effect of reconstruction of the soft tissue of the thumb/finger defects by the second toe tibial toe pulp skin flap. Methods Ten patients with the soft tissue of pulp of the thumb/finger defects were treat by the same side of the second toe tibial toe pulp skin flap, all the patients have the soft tissue defect of finger pulp with exposed phalanx. Crush them in 4 cases, the machine cut wound in 6 cases. A fixed 2 cases, delayed operation 3-7d after injury to repair in 8 patients. The side of skin flap varied from 2.0 cm × 2.2 cm to 2.0 cm × 3.5 cm. Results Ten fingers in 10 cases all survived. Necrosis in edge part of the shin graft occurred in 2 cases, which was healed through changing of dressing. All cases were followed form 4 months to 16 months. The blood-supply, texture and elasticity of transferred flaps and the shape of fingers pulp were excellent. Good function recovery of the fingers was achieved. Pain and temperature sence were regained. Two point discrimination of the finger pulp was 5-9 mm.Primary healing occurred in all cases. It did not disturb dressing shoes and walking. Conclusion It is a reliable approach for soft-tissue coverage of the thumb/finger using the second toe tibial toe pulp skin flap based on distal perforators of digital artery or ulnar artery. The advantages include simply procedures, reliable blood supply without sacrificing main aneries and possibilities of sensoly recovery.

Free flap transplantation in the reconstruction of large area defects in head and neck / 中华显微外科杂志

Objective To review clinical experience of free flap transferring in the reconstruction of head and neck defects. Methods Fifteen free anterolateral thigh flaps, 5 free deep inferior epigastric flaps and 3 free lateral arm flaps were used to reconstruct large area head and neck defects. Results All 23 free flaps were alive with good appearance. 1 case survived by performing embolectomy after suffering arterial crisis and delayed recovery of wound took place in 2 cases. Conclusion Free flap transplantation is an ideal choice for reconstructing large area cranio-facio-cervical defects.