The Reconstruction of Soft tissue Defect of the Fingerwith Medial Plantar Septo-cutaneous Free Flap.

Kae, Min Seok; Yoon, Eul Sik; Koo, Sang Hwan; Ahn, Duck Sun; Park, Seung Ha

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 1999;26(4):720-724.
Published online July 1, 1999.

The Reconstruction of Soft tissue Defect of the Fingerwith Medial Plantar Septo-cutaneous Free Flap.

Min Seok Kae, Eul Sik Yoon, Sang Hwan Koo, Duck Sun Ahn, Seung Ha Park

Abstract

Various surgical methods have been used to reconstruct severe soft tissue defects of the finger with exposed critical structures such as tendon, bone, and nerve. Some of these methods include rotation flap, cross finger flap, or regional flap similar to neurovascular island flap. However, there were often difficult situations where a flap could not be applied depending on the remaining surrounding tissue, injured area, and size of defect. As a result, free flap or distant flap may become necessary. However, distant flaps often cause stiffness of the finger joints since the hands need to be immobilized for a long time, while standard free flaps may be too thick to cover the finger and cause problems such as morbidities of the donor site. Since May, 1997, at Anam Hospital, we have performed reconstruction on 6 patients with soft tissue defect using a thin, flexible medial plantar septo-cutaneous free flap similar to the volar aspect of the finger in anatomical characteristics of the skin and subcutaneous tissue covering. The vessels used for this flap were superficial branches of medial division of the medial plantar artery and vena comitantes, or the subcutaneous veins. The mean size of the flaps was 2.75cm x 4.25cm. Primary repair or split-thickness skin graft was performed on the donor site depending on the size. All the flaps survived without significant complications, except one case of venous insufficiency. The composition of the transferred flaps was good with the recovery of pain, touch and temperature sensation. A free medial plantar septo-cutaneous flap has several advantages, e.g., it is small in comparison with other standard free flaps, having two draining venous pathways, good color and texture, and a good recovery of protective sensation. This flap can be used for the reconstruction of soft tissue defect on the heel and foot, as well as the volar aspect of fingers.

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