Forty-seven extremities were operated upon by the various flap methods on forty patients. [See Table in PDF Source]
Analyzing the causes of failures in groups 1 and 3 (syndactylism and palm and finger contractures), the only ones large enough to permit of conclusions, there were errors in judgment as well as in technique. Errors in judgment occurred chiefly in the selection of local flaps, shift flaps, etc., when pedunculated flaps after the Italian method would have been better. Errors in technique consisted mostly in undersizing of the flaps when pedunculated, in undue tension of local flaps, and in allowing wound secretion to accumulate under the flaps, and in formation of bases of flaps too narrow for adequate nutrition. Since all these points were given due regard in later operations the operative results have become much more satisfactory.
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