Free fasciocutaneous flaps for reconstruction of complete circumferential degloving injury of digits
Article first published online: 19 DEC 2012
Copyright © 2012 Wiley Periodicals, Inc.
Volume 33, Issue 3, pages 191–197, March 2013
How to Cite
Lin, C.-T., Chen, S.-G., Chen, T.-M., Dai, N.-T. and Chang, S.-C. (2013), Free fasciocutaneous flaps for reconstruction of complete circumferential degloving injury of digits. Microsurgery, 33: 191–197. doi: 10.1002/micr.22064
- Issue published online: 15 MAR 2013
- Article first published online: 19 DEC 2012
- Manuscript Accepted: 5 OCT 2012
- Manuscript Revised: 29 SEP 2012
- Manuscript Received: 3 JAN 2012
Complete circumferential degloving injury of the digits usually results in a large cutaneous defect with tendinous structure and bone and joint exposure. When revascularization is not possible, a thin and adequately sized flap is required to resurface the defect, restore finger function, and prevent amputation. In this report, we present our experience with reconstruction of the entire circumferential degloving injury of the digits using free fasciocutaneous flaps. Between February 2006 and January 2011, 9 male patients with circumferential degloving injury of 9 digits underwent reconstruction using free fasciocutaneous flap transfer with the posterior interosseous artery flap, medial sural artery flap, anteromedial thigh flap, or radial forearm flap. The average flap size was 14.2 × 6.9 cm. Donor sites were closed primarily or covered with split-thickness skin graft. All flaps survived completely and the donor sites healed without complications. The mean follow-up period was 34.8 months. A maximum Kapandji score (10/10) was seen in 2 cases with crushed thumbs. All patients could achieve good key pinch and grasping functions. All skin flaps showed acceptable static 2-point discrimination and adequate protective sensation. Patient satisfaction for resurfaced digits averaged 9 on a 10-points visual analogic scale. In conclusion, the free fasciocutaneous flaps used were thin and did not interfere with finger movements. The patient's finger formed a smooth contour and acceptable functional results were obtained after reconstruction. This method may be a valuable alternative for reconstruction of entire circumferential avulsion injury of the digits. © 2012 Wiley Periodicals, Inc. Microsurgery, 2013.