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CC BY-NC-ND 4.0 · Indian J Plast Surg 2023; 56(05): 451-456
DOI: 10.1055/s-0043-1775868
Case Series

Homodigital Unipedicled Islanded Neurovascular Pulp Advancement Flap/Colombo Flap for Fingertip Reconstruction: A Case Series with a Novel Technique

Jeewan Pradeep Rankothkumbura 
1   Plastic and Reconstructive Surgical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka
,
Iddagoda Hewage Don Samitha Prasad
1   Plastic and Reconstructive Surgical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka
,
Gamini Kaushalya Gayamali
1   Plastic and Reconstructive Surgical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka
,
Dammika Abeywickrama Dissanayake
1   Plastic and Reconstructive Surgical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka
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Abstract

Fingertip injury is the most common type of upper extremity injury. Operative treatment with flap cover is required for tissue loss causing bone exposure and when there is a compelling need to preserve the length, unless microvascular replantation is possible. There are many techniques described for this purpose offering varying degrees of good outcomes. Yet there are limitations and long-term problems. We report a case series with a novel technique named “Colombo flap,” which is a neurovascular islanded advancement flap based on a single pedicle. Five fingers of four consented patients were operated using this technique and they were followed up for 2.5 years. All had satisfactory sensory recovery (S3 +/S4), preserved range of motion (ROM) at interphalangeal joints, good grip strengths, and satisfactory outcomes based on Michigan Hand Questionnaire (MHQ). There were no complications such as flap necrosis, infection, and neuroma formation. Hook nail deformity was minimal and none had pain or cold intolerance.

Keywords

fingertip injuries - advancement flaps - pedicled flaps - neurovascular flaps

Ethical Approval

This study conforms to the Declaration of Helsinki.




Publication History

Article published online:
16 October 2023

© 2023. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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