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One-stage coverage of multi-digital pulp defects with sensate flaps from the foot

  • Lin Tang
    Affiliations
    Department of Orthopedic Hand Surgery, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
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  • Xin Zhou
    Affiliations
    Department of Orthopedic Hand Surgery, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
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  • Yong gen Zou
    Correspondence
    Corresponding author at: 16 Chunhui Avenue, Longma Tan District, Luzhou, Sichuan 646000, China.
    Affiliations
    Department of Orthopedic Hand Surgery, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
    Search for articles by this author
Published:December 31, 2021DOI:https://doi.org/10.1016/j.injury.2021.12.050

      Highlights

      • Offer one-stage producer for multi-digital pulp defects with sensate flaps without any amputation.
      • As a vigorous donor with great potential, the foot may provide a desirable tissue reserve for covering the digital lesions where sensitivity and thinned skin are required with proper bulkiness and allows for easy dissection. The sensate flap from the foot is a remarkable alternative for digital pulp reconstruction with less morbidity and better outcomes;.
      • The one-staged reconstruction is potentially superior method as it minimizes scarring and reduces recovery period, especially if it allows early mobilization, the functional results in pulp reconstruction would be achieved;.
      • The foot performed a better esthetic outcome with an inconspicuous site.

      Abstract

      Background

      The reconstruction of the digital pulp defects was a mix of the sensation, function, and aesthetics. As the conventional flaps became out of date, the sensate flaps were increasingly utilized in covering such defects. In this report, we present our experience with some novel flaps design, located on the foot.

      Method

      From April 2015 to September 2018, nine patients received the free sensate flaps to resurface soft tissue defects in the multi-digital pulps. And all flaps were harvested from each aspect of the foot, which dimensions were tailored to the defects. The cutaneous nerve was preserved within the flap. Standardized assessment of outcome in terms of sensory, functional, and esthetic scores of the reconstructed pulps was completed.

      Results

      Nineteen flaps survived completely without significant complications, and mild venous congestion was observed in one flap. The free sensate flaps were performed for digital pulp reconstruction in 9 patients: 6 male and 3 female patients with a mean age of 49 years (ranged, 16 to 72 years). The defects involved 3 thumbs, 6 index fingers, 5 long fingers, 3 ring fingers, and 2 little fingers. All flaps were available for a mean follow-up of 30 months (ranged, 24 to 36 months). The functional and esthetic outcomes were satisfied for all flaps, as well as the sensory restoration.

      Conclusion

      The sensate flap from the foot is a remarkable alternative for digital pulp reconstruction with less morbidity and better outcomes. Furthermore, the foot region presents a sensitive, glabrous skin with the proper bulkiness and allows for easy dissection.

      Keywords

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