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Anatomical and Clinical Comparison of Small Free Flaps for Repairing Finger Skin Defects

He, Bo MD, PhD*,†; Liu, Jianghui MD, PhD; Pang, Vincent MD; Zhu, Lei MD, MS§; Huang, Yongjun MD; Wang, Zengtao MD; Xu, Yangbin MD, PhD; Zhu, Zhaowei MD, PhD; Wang, Kun MD, PhD*

doi: 10.1097/SAP.0000000000001933
Microsurgery
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The reconstruction of finger defects requires improved functional outcomes and acceptable esthetic outcomes, and small free flaps present a good alternative technique for repairing finger skin defects. From January 2006 to December 2018, we investigated the number and diameter of proximal digital artery perforators, medial plantar artery perforators, and peroneal proper plantar digital arteries of the hallux by dissection and then transplanted free digital arterial perforator flaps, free medial plantar flaps, and free peroneal flaps from the hallux to repair small finger skin defects. The number (SD) of perforators from the medial plantar artery was approximately 2.2 (0.5), and these perforators measured 0.53 (0.20) mm in diameter. The diameter (SD) of the first metatarsal dorsal artery was approximately 1.16 (0.30) mm. A total of 25 patients were included in this study. The transplantation times (SD) for free digital arterial perforator flaps, free medial plantar flaps, and free peroneal flaps from the hallux were 3.5 (0.5) hours, 3.2 (0.7) hours, and 2.0 (0.4) hours, respectively. The follow-up period ranged from 8 to 15 months. All flaps survived and were appropriately shaped. The donor site was either covered with a free flap or directly sutured. Among these 3 types of small flaps, the free peroneal flap from the hallux can be recommended for clinical use because of the large diameter of the contributing vessels, the short operative time, the ease of access, and the improved appearance of the donor site.

From the *Department of Orthopedics, The Third Affiliated Hospital of Sun Yat-Sen University

Departments of Emergency Medicine

Plastic Surgery, The First Affiliated Hospital of Sun Yat-Sen University

§Department of Plastic Surgery, The Third Affiliated Hospital of Sun Yat-Sen University

Department of Orthopedics, Guangdong Second Provincial General Hospital, Guangzhou

Department of Hand and Foot Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.

Received October 19, 2018, and accepted for publication, after revision February 15, 2019.

Conflicts of interest and sources of funding: This research was supported by the Medical Scientific Research Foundation of Guangdong Province (A2016018), the National Natural Science Foundation of China (81201546), the Science and Technology Project of Guangdong Province (2016A010103012), and the Doctoral Start-up Project of the Natural Science Foundation of Guangdong Province (2017A0310302). None of the authors declare any conflicts of interest.

B.H. and J.L. contributed equally to the article as co-first authors.

Reprints: Yangbin Xu, MD, PhD, Department of Plastic Surgery, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, China. E-mail: xuyangbin@hotmail.com; Zhaowei Zhu, MD, PhD, Department of Plastic Surgery, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Rd 2, Guangzhou 510080, China. E-mail: nmtmemoir@aliyun.com; or Kun Wang, MD, PhD, Department of Orthopedics, The Third Affiliated Hospital of Sun Yat-Sen University, No. 600 Tianhe Rd, Tianhe District, Guangzhou, Guangzhou 510000, China. E-mail: dr_wangkun333@163.com.

Online date: June 7, 2019

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