Fingertip reconstruction with a subcutaneous flap and composite graft composed of nail bed and volar pulp skin
- Author:
Sung Hoon KOH
1
;
Ilou PARK
;
Jin Soo KIM
;
Dong Chul LEE
;
Si Young ROH
;
Kyung Jin LEE
;
Min Ki HONG
Author Information
- Publication Type:Original Article
- From:Archives of Plastic Surgery 2022;49(1):70-75
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Fingertip injuries are very common; however, the reconstruction of volar pulp defects with nail bed defects is challenging in the absence of the amputated segment. We reconstructed fingertip amputations with nail bed defects using a new surgical approach: a subcutaneous flap and composite graft.
Methods:We treated 10 fingertip amputation patients without an amputated segment, with exposed distal phalangeal bone and full-thickness nail bed defects between February 2018 and December 2020. All patients underwent two-stage surgery: in the first stage, a subcutaneous flap was performed to cover the exposed distal phalanx, and in the second stage, a composite graft, consisting of nail bed, hyponychium, and volar pulp skin, was applied over the subcutaneous flap.
Results:All flaps survived and all composite grafts were successful. The wounds healed without any significant complications, including the donor site. The average follow-up duration was 11.2 months (range, 3–27 months). The new nail and the shape of the volar pulp were evaluated during follow-up. All patients were satisfied with their natural fingertip shapes and the new nails did not have any serious deformities.
Conclusions:A subcutaneous flap in combination with a composite graft fitting the shape of the defect could be another option for fingertip injuries without amputated segments.
