Article
Long-term outcome of innervated digital artery perforator flap
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Authors
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Ali Cavit
- Uludag University Faculty of Medicine, Bursa, Turkey
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Haluk Ozcanli
- Akdeniz University Faculty of Medicine, Antalya, Turkey
| Published: | February 6, 2020 |
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Outline
Text
Objectives/Interrogation: The aim of study is to evaluate long-term clinical outcomes of the patients who underwent reconstruction with innervated digital artery perforator flap (IDAP) flap in the treatment of fingertip tissue loss.
Methods: 83 patients (93 fingers) who were operated due to fingertip amputations between August 2011 - October 2016 were included in the study. Acute or late reconstructions were performed to the fingertip injuries with the use of IDAP flap. Mean age of the patients was 35.2 years (range 5-65 years). Objective and subjective evaluations were performed in the postoperative controls. Statistical two-point discrimination (s2PD) and Semmes-Weinstein monofilament (SWM) tests were performed as objective parameters in comparison with contralateral hand. Range of motions of the reconstructed fingers were evaluated. Conditions that affect regional blood flownegatively (diabetes mellitus, vasospastic problems, smoking etc.) were questioned. Subjective assessment parameters consisted of hypersensitivity, cold intolerance and patient.
Results and Conclusions: The mean follow-up period was 33.1 months (range 12-60 months). The static 2-point discrimination measured on the flaps ranged from 2 mm to 6 mm (mean 3.7 mm); compared with 2 mm to 5 mm (mean 2.7 mm) on the contralateral fingers. Semmes-Weinstein test results ranged from 2.44 to 4.31 on the contralateral fingers, compared with 2.44 to 4.56 on reconstructed fingers. No partial or total flap loss was observed in any of the patients. There was no donor site morbidity. Superficial epidermolysis was observed in 4 fingers (4.3%). However, no second surgical procedure was applied to any patient. 4.3% of the 93 fingers (4 fingers) had hyperesthesia. Mild cold intolerance was observed in 18 fingers (19.3%). When evaluating both functional and aesthetic conditions of the patient, 75 patients (90.3%) reported being "very good" and 8 patients (9.7%) reported being "good".
The innervated digital artery perforator flap is a quick, sensory, reliable and versatile flap with excellent functional and aesthetic results, which can be used for early and late reconstructions of all types of fingertip defects.
