Subscribe to RSS
Download PDF
DOI: 10.5999/aps.2016.43.1.66
Donor-Site Morbidity after Partial Second Toe Pulp Free Flap for Fingertip Reconstruction
Authors
Background In this study, we characterize the morbidity at the donor-site of partial second toe pulp free flaps in terms of wound management as well as long-term outcomes.
Methods A single-institutional retrospective review was performed for patients who had undergone partial second toe pulp free flap transfer to the fingertip. Patient charts were reviewed for infection, skin necrosis, wound dehiscence, and hematoma for the donor site. Additionally, a questionnaire survey was given to patients who had a follow-up of longer than 1 year to characterize long-term postoperative pain and appearance.
Results The review identified a total of 246 cases. Early wound complications were significant for wound dehiscence (n=8) and hematoma (n=5) for a wound complication rate of 5.3%. The questionnaire was distributed to 109 patients, and 54 patients completed the survey. Out of these 54 patients, 15 patients continued to have donor-site pain (28%) at a mean follow-up period of 32.4 months. However, the pain intensity was relatively low in the range between 2 to 5, on a 0–10 scale. None of these patients felt this donor-site pain interfered significantly with daily activity, nor did any patient require pain medications of any type. Donor-site appearance was satisfactory to most patients.
Conclusions The partial second toe pulp flap was associated with low rates of wound complications and favorable long-term outcomes. Given the functional and aesthetic gain in the recipient finger, donor-site morbidities appear acceptable in this patient population. This study can be helpful in counseling patients regarding donor-site morbidity during the informed consent process.
Publication History
Received: 15 June 2015
Accepted: 17 August 2015
Article published online:
20 April 2022
© 2016. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Lee DC, Kim JS, Ki SH. et al. Partial second toe pulp free flap for fingertip reconstruction. Plast Reconstr Surg 2008; 121: 899-907
- 2 Bickel KD, Dosanjh A. Fingertip reconstruction. J Hand Surg Am 2008; 33: 1417-1419
- 3 Lister G. Local flaps to the hand. Hand Clin 1985; 1: 621-640
- 4 Thoma A, Vartija LK. Making the V-Y advancement flap safer in fingertip amputations. Can J Plast Surg 2010; 18: e47-e49
- 5 O'Brien B. Neurovascular island pedicle flaps for terminal amputations and digital scars. Br J Plast Surg 1968; 21: 258-261
- 6 Cohen BE, Cronin ED. An innervated cross-finger flap for fingertip reconstruction. Plast Reconstr Surg 1983; 72: 688-697
- 7 Buncke HJ, Rose EH. Free toe-to-fingertip neurovascular flaps. Plast Reconstr Surg 1979; 63: 607-612
- 8 Logan A, Elliot D, Foucher G. Free toe pulp transfer to restore traumatic digital pulp loss. Br J Plast Surg 1985; 38: 497-500
- 9 Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. J Clin Nurs 2005; 14: 798-804
- 10 Remerand F, Godfroid HB, Brilhault J. et al. Chronic pain 1 year after foot surgery: epidemiology and associated factors. Orthop Traumatol Surg Res 2014; 100: 767-773
- 11 Bouhassira D, Attal N, Alchaar H. et al. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain 2005; 114: 29-36
- 12 Ratcliffe RJ, McGrouther DA. Free toe pulp transfer in thumb reconstruction: experience in the West of Scotland Regional Plastic Surgery Unit. J Hand Surg Br 1991; 16: 165-168