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An Improvement in Dorsal Reverse Adipofascial Flap for Fingertip Reconstruction: Nail Matrix Preservation

Hoşnuter, Mübn MDı; Kargi, Eksal MD; Işikdemr, Ahmet MDı

doi: 10.1097/01.sap.0000168692.59902.1d
Original Article
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Dorsal reverse adipofascial flap (DRAF) is one of the most reliable choices for reconstruction of fingertip amputations. A drawback of this method is matrixectomy, which is routinely performed in distal phalangeal amputations, even when the germinal matrix and some nail bed is intact. However, the nail is important for both functional and esthetic reasons and should not be killed. We described a new approach to DRAF, in selected cases, for preserving the nail. As a result, we obtained useful and esthetic fingertip with a nail unit.

Nine turnover dorsal reverse adipofascial flaps with skin grafting were performed for fingertip reconstruction. Preservation of the nail matrix permitted the nail to regrow and perforate the flap secondarily.

From Zonguldak Karaelmas University, Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Zonguldak, Turkey.

Received February 12, 2005 and accepted for publication, after revision, April 7, 2005.

Peprints: Mübın Hoşnuter, MD, Zonguldak Karaelmas Üniversitesi Tıp Fakültesi Hastanesi, Plastik ve Rekonstrüktif Cerrahi Anabilim Dalı, Kozlu 67600, Zonguldak, Turkey. E-mail: hosnuter@yahoo.com.

© 2005 Lippincott Williams & Wilkins, Inc.