gms | German Medical Science

Objectives/Interrogation: To explore the surgical indications, techniques and curative effects of both hand and donor foot reconstruction with different types of big toe wrap-around flap and free perforator flap.

Methods: From February 2012 to October 2017, 102 fingers in 65 cases were reconstructed. A variety of wrap around flaps and perforator flaps were designed and transferred to reconstruct the hands and donor feet respectively. Single thumb reconstruction: I degree (11 fingers in 11 cases), II degree (25 fingers in 24 cases), III degree (5 fingers in 5 cases). Fingers reconstruction including thumb: two fingers (12 fingers in 5 cases), three fingers (12 fingers in 4 cases), four fingers (8 fingers in 2 cases). Fingers reconstruction except thumb: single finger (5 fingers in 5 cases), two fingers (6 fingers in 3 cases), three fingers (18 fingers in 6 cases). Secondary foot skin or bone defect: repaired with perforator flap (49 cases)or chimeric superficial circumflex iliac artery perforator flap (16 cases).

Results and Conclusions: All reconstructed fingers survived at last. Most of flaps for foot repair survived except partial necrosis in 3 cases and complete necrosis in 1 case. The follow-up ranged from 5 to 28 months. According to evaluation criteria from Chinese Medicine Association for hand surgery: excellent in 47 cases, good in 18 cases. According to the Maryland foot function score standard: excellent in 52 cases, good in 13 cases. Conclusion These described procedures can not only get the excellent outcome of reconstructed fingers based on minimal morbidity in the donor site but also provide a new treatment option for degloving hand that need multiple fingers reconstruction.