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Year : 2019  |  Volume : 27  |  Issue : 1  |  Page : 14-18

Complicated fingertip defects: Clinical approach to their reconstruction and the flaps that can be used in emergency settings

1 Department of Plastic Reconstruction and Aesthetic Surgery, Okmeydani Training and Research Hospital, Istanbul, Turkey
2 Department of Plastic Reconstruction and Aesthetic Surgery, Medical Park Hospital Bursa, Turkey
3 Department of Plastic Reconstruction and Aesthetic Surgery, Liv Hospital Istanbul, Istanbul, Turkey

Correspondence Address:
Dr. Ozlem Colak
Okmeydani Research and Training Hospital, Department of Aesthetic, Plastic and Reconstructive Surgery, Darulaceze Cad No: 25, Sisli, Istanbul
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjps.tjps_43_18

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Aim: Numerous flaps have been described for the reconstruction of complicated defects of the fingertip. The aim of this study was to evaluate our experience on flaps that can be used in emergency settings, and analyze the outcomes of these procedures. Materials and Methods: A retrospective analysis of 81 patients, who presented to the emergency unit with complicated fingertip defects between 2009 and 2014 and in whom replantation was deemed unsuitable due to various reasons including crush or avulsion type of injury mechanism, absence of the amputated part, or unrepairable vascular injury in the amputate, was carried out. Results: Eighty-nine flaps were performed in 81 patients. The defects were repaired with V-Y advancement flaps in 57% (45 patients – 51 fingers) of the defects, kite flap in 15% (13 patients – 13 fingers), cross-finger flap in 12% (11 patients – 11 fingers), Kutler flap in 6% (4 patients – 5 fingers), digital artery perforator flap in 6% (4 patients – 5 fingers), and thenar flap in 4% (4 patients – 4 fingers) of the injuries. One patient operated with the digital artery perforator flap, and one other operated with the kite flap, developed partial flap necroses. There were no other complications. Conclusion: Functional and esthetic restoration of soft tissues in the fingers is possible with the use of appropriate flaps and meticulous surgical technique.

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