gms | German Medical Science

Objectives/Interrogation: To evaluate the clinical outcome of the method of repairing donor site of foot after improved Toe-to-thumb reconstruction utilizing superficial circumflex iliac artery perforator (SCIAP) chimeric flap.

Methods: Fourteen cases of thumb defect were recruited in our hospital from April 2012 to January 2016. According to Gu Yudong's classification 5 cases met the criterion of type I, 4 cases met the criterion of type II, and 5 cases met the criterion of type III. For type I, the thumb was reconstructed with the great toe wrap-around flap. For type II and III, the thumb was reconstructed by the combined tissue with mutual artery (great toe wrap-around flap, and the bone-tendon tissue of the second toe). All the donor sites of foot were repaired utilizing SCIAP chimeric flap.

Results and Conclusions: All the reconstructed thumbs survived. Among 14 free flaps of donor site, 1 case suffered venous crisis and survived after exploration and rescue surgery. Dorsal skin necrosis of the second toe was found in 1 case, which was healed by local skin flap transposition. All patients were followed-up ranged from 3 months to 30 months (average time was 16 months). In spite of slightly bloated, all the flaps' color and texture was satisfied, and the average healing time of the bone in the donor sites was 2.5 months. All the patients did not feel painful and had no adverse effect when walking and running. Three months after the operation, 5 slightly bloated flaps in the donor sites under went flap plastic and achieved better appearance. On the part of iliaca, there was only one inconspicuous linear scar without any discomfort.

Repairing donor site of foot after improved Toe-to-thumb reconstruction utilizing SCIAP chimeric flap was an ideal method. Using this method, the reconstructed thumb can achieve good appearance and function, all the toes of donor site were reserved, and the disability of the donor site was minimized.