Treatment of fingertip defect with reversed digital artery island flap through superficial vein anastomosis

• Published in: ANZ journal of surgery 2021-09, Vol.91 (9), p.E584-E588
• Main Authors: Lan, Xianfeng, Huang, Yuming, Guo, Liang, Lin, Jingui
• Format: Article
• Language: English
• Subjects: Anastomosis; Complications; Congestion; Defects; fingertip defect; Maintenance; microscopy; Patients; Regression analysis; reversed digital artery island flap; superficial vein anastomosis; Veins; Veins & arteries; Wear resistance
• ISSN: 1445-1433; 1445-2197
• DOI: 10.1111/ans.16698

Reversed digital artery island flap is a safe and effective method for the treatment of fingertip defects. Anastomosis of the superficial veins and reduction of the flap area and surgical time may significantly reduce the incidence of venous congestion. Background This study prospectively explored the clinical effect of a reversed digital artery island flap (RDAIF) in repairing fingertip defects and the impact of the anastomosis of superficial veins in the recipient area on the incidence of venous crisis. Methods A total of 92 patients with fingertip defects who underwent RDAIF from February 2016 to February 2018 were enrolled in this prospective, randomized, controlled trial. Of these, 44 patients underwent superficial vein anastomosis. The perioperative data, clinical efficacy and complications of the two groups were compared by the chi‐squared test and binary logistic regression analysis. Results The average follow‐up time was 7.0 ± 2.9 months. The incidence of venous congestion was significantly correlated with flap size, surgical time and anastomosis of superficial veins (Wald = 6.512, 9.353 and 11.662; P = 0.011, 0.002 and 0.001, respectively). The fingertips of the two groups of patients were well repaired, wear resistant and stable in holding, and the two‐point discrimination was 5–8 mm. Conclusion RDAIF is a safe and effective method for the treatment of fingertip defects, especially in patients who require maintenance of function or contour of the fingertip. Anastomosis of the superficial veins and reduction of the flap area and surgical time can significantly reduce the incidence of venous congestion.