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Dijital arter perforatör flepler: Parmak ucu ampütasyonu onarımında kolay ve güvenilir bir seçenek

Year 2013, Volume: 47 Issue: 4, 250 - 254, 18.09.2013

Abstract

Amaç: Bu çalışmanın amacı parmak ucu rekonstrüksiyonunda dijital arter perforatör (DAP) fleplerinin kullanımı ve etkinliğini incelemekti.
Çalışma planı: Travmatik parmak ucu ampütasyonu sonrası, 2007 ila 2011 yılları arasında 5 hastanın (4 erkek, 1 kadın) 7 parmak ucunun genişletilmiş DAP flebi kullanılarak rekonstrüksiyonu yapıldı. Ortalama flep boyu 4.25 cm2 idi.
Bulgular: Bir hasta haricinde bütün flepler yaşadı. Bu hastamızda gözlenen parsiyel deri nekrozu ıslak pansuman ile tedavi edildi. Beş parmakta verici alana tam kalınlıkta deri grefti kondu, diğer iki hastada verici alan primer olarak kapatıldı. Onarım yapılan parmakların hiçbirinde hipersensitivite ya da soğuk intoleransı gözlenmedi.
Çıkarımlar: Dijital arter perforatör flep güvenilir bir serbest-stil perforatör flep olarak tüm parmak ucu yaralanmalarında kullanılabilir.

References

  • Mitsunaga N, Mihara M, Koshima I, Gonda K, Takuya I, Kato H, et al. Digital artery perforator (DAP) flaps: modifi- cations for fingertip and finger stump reconstruction. J Plast Reconstr Aesthet Surg 2010;63:1312-7.
  • Atasoy E, Ioakimidis E, Kasdan ML, Kutz JE, Kleinert HE. Reconstruction of the amputated finger tip with a triangular volar flap. A new surgical procedure. J Bone Joint Surg Am 1970;52:921-6.
  • Evans DM, Martin DL. Step-advancement island flap for finger-tip reconstruction. Br J Plast Surg 1988;41:105-11.
  • Tempest MN. Cross-finger flaps in the treatment of injuries to the finger tip. Plast Reconstr Surg (1946) 1952;9:205-22.
  • Smith JR, Bom AF. An evaluation of finger-tip reconstruc- tion by cross-finger and palmar pedicle flap. Plast Reconstr Surg 1965;35:409-18.
  • Miller AJ. Single finger tip injuries treated by thenar flap. Hand 1974;6:311-4.
  • Melone CP Jr, Beasley RW, Carstens JH Jr. The thenar flap – An analysis of its use in 150 cases. J Hand Surg Am 1982;7:291-7.
  • O’Brien B. Neurovascular island pedicle flaps for terminal amputations and digital scars. Br J Plast Surg 1968;21:258- 61.
  • Lai CS, Lin SD, Yang CC. The reverse digital artery flap for fingertip reconstruction. Ann Plast Surg 1989;22:495-500.
  • Niranjan NS, Armstrong JR. A homodigital reverse pedicle island flap in soft tissue reconstruction of the finger and the thumb. J Hand Surg Br 1994;19:135-41.
  • Koshima I, Inagawa K, Urushibara K, Okumoto K, Moriguchi T. Fingertip reconstructions using partial-toe transfers. Plast Reconstr Surg 2000;105:1666-74.
  • Koshima I, Urushibara K, Fukuda N, Ohkochi M, Nagase T, Gonda K, et al. Digital artery perforator flaps for finger- tip reconstructions. Plast Reconstr Surg 2006;118:1579-84.
  • Uysal A, Kankaya Y, Ulusoy MG, Sungur N, Karalezli N, Kayran O, et al. An alternative technique for microsurgical- ly unreplantable fingertip amputations. Ann Plast Surg 2006;57:545-51.
  • Chen SY, Wang CH, Fu JP, Chang SC, Chen SG. Composite grafting for traumatic fingertip amputation in adults: technique reinforcement and experience in 31 digits. J Trauma 2011;70:148-53.
  • Kayalar M, Bal E, Toros T, Sügün ST, Özaksar K, Gürbüz Y. The outcome of direct-flow neurovascular island flaps in pulp defects. Acta Orthop Traumatol Turc 2011;45:175-84.
  • Kayalar M, Bal E, Toros T, Özaksar K, Sügün ST, Ademo¤lu Y. The results of reverse-flow island flaps in pulp reconstruction. Acta Orthop Traumatol Turc 2011;45:304- 11.
  • Suzuki S, Koshima I. Digital artery perforator flap for recon- struction of fingertip after resection of melanoma in situ. Hand Surg 2011;16:395-8.

Digital artery perforator flaps: an easy and reliable choice for fingertip amputation reconstruction

Year 2013, Volume: 47 Issue: 4, 250 - 254, 18.09.2013

Abstract

Objective: The aim of this study was to evaluate the use and efficacy of digital artery perforator (DAP) flaps in fingertip reconstruction.
Methods: From 2007 to 2011, 7 fingers of 5 patients (4 male, 1 female) underwent fingertip reconstruction with extended DAP flaps following traumatic fingertip amputation. Average flap size was 4.25 cm2.
Results: All flaps survived except one case in which partial skin necrosis was observed and treated with wet-dressing. Donor sites were closed with full-thickness skin grafting in 5 and primarily in 2 fingers. We did not observe hypersensitivity or cold intolerance in repaired fingers.
Conclusion: The DAP flap is a reliable, free-style perforator flap that can be used for all types of fingertip injuries.

References

  • Mitsunaga N, Mihara M, Koshima I, Gonda K, Takuya I, Kato H, et al. Digital artery perforator (DAP) flaps: modifi- cations for fingertip and finger stump reconstruction. J Plast Reconstr Aesthet Surg 2010;63:1312-7.
  • Atasoy E, Ioakimidis E, Kasdan ML, Kutz JE, Kleinert HE. Reconstruction of the amputated finger tip with a triangular volar flap. A new surgical procedure. J Bone Joint Surg Am 1970;52:921-6.
  • Evans DM, Martin DL. Step-advancement island flap for finger-tip reconstruction. Br J Plast Surg 1988;41:105-11.
  • Tempest MN. Cross-finger flaps in the treatment of injuries to the finger tip. Plast Reconstr Surg (1946) 1952;9:205-22.
  • Smith JR, Bom AF. An evaluation of finger-tip reconstruc- tion by cross-finger and palmar pedicle flap. Plast Reconstr Surg 1965;35:409-18.
  • Miller AJ. Single finger tip injuries treated by thenar flap. Hand 1974;6:311-4.
  • Melone CP Jr, Beasley RW, Carstens JH Jr. The thenar flap – An analysis of its use in 150 cases. J Hand Surg Am 1982;7:291-7.
  • O’Brien B. Neurovascular island pedicle flaps for terminal amputations and digital scars. Br J Plast Surg 1968;21:258- 61.
  • Lai CS, Lin SD, Yang CC. The reverse digital artery flap for fingertip reconstruction. Ann Plast Surg 1989;22:495-500.
  • Niranjan NS, Armstrong JR. A homodigital reverse pedicle island flap in soft tissue reconstruction of the finger and the thumb. J Hand Surg Br 1994;19:135-41.
  • Koshima I, Inagawa K, Urushibara K, Okumoto K, Moriguchi T. Fingertip reconstructions using partial-toe transfers. Plast Reconstr Surg 2000;105:1666-74.
  • Koshima I, Urushibara K, Fukuda N, Ohkochi M, Nagase T, Gonda K, et al. Digital artery perforator flaps for finger- tip reconstructions. Plast Reconstr Surg 2006;118:1579-84.
  • Uysal A, Kankaya Y, Ulusoy MG, Sungur N, Karalezli N, Kayran O, et al. An alternative technique for microsurgical- ly unreplantable fingertip amputations. Ann Plast Surg 2006;57:545-51.
  • Chen SY, Wang CH, Fu JP, Chang SC, Chen SG. Composite grafting for traumatic fingertip amputation in adults: technique reinforcement and experience in 31 digits. J Trauma 2011;70:148-53.
  • Kayalar M, Bal E, Toros T, Sügün ST, Özaksar K, Gürbüz Y. The outcome of direct-flow neurovascular island flaps in pulp defects. Acta Orthop Traumatol Turc 2011;45:175-84.
  • Kayalar M, Bal E, Toros T, Özaksar K, Sügün ST, Ademo¤lu Y. The results of reverse-flow island flaps in pulp reconstruction. Acta Orthop Traumatol Turc 2011;45:304- 11.
  • Suzuki S, Koshima I. Digital artery perforator flap for recon- struction of fingertip after resection of melanoma in situ. Hand Surg 2011;16:395-8.
There are 17 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Salih Onur Basat This is me

Alper Mete Ugurlu This is me

Atakan Aydın This is me

Tolga Aksan This is me

Publication Date September 18, 2013
Published in Issue Year 2013 Volume: 47 Issue: 4

Cite

APA Basat, S. O., Ugurlu, A. M., Aydın, A., Aksan, T. (2013). Digital artery perforator flaps: an easy and reliable choice for fingertip amputation reconstruction. Acta Orthopaedica Et Traumatologica Turcica, 47(4), 250-254.
AMA Basat SO, Ugurlu AM, Aydın A, Aksan T. Digital artery perforator flaps: an easy and reliable choice for fingertip amputation reconstruction. Acta Orthopaedica et Traumatologica Turcica. September 2013;47(4):250-254.
Chicago Basat, Salih Onur, Alper Mete Ugurlu, Atakan Aydın, and Tolga Aksan. “Digital Artery Perforator Flaps: An Easy and Reliable Choice for Fingertip Amputation Reconstruction”. Acta Orthopaedica Et Traumatologica Turcica 47, no. 4 (September 2013): 250-54.
EndNote Basat SO, Ugurlu AM, Aydın A, Aksan T (September 1, 2013) Digital artery perforator flaps: an easy and reliable choice for fingertip amputation reconstruction. Acta Orthopaedica et Traumatologica Turcica 47 4 250–254.
IEEE S. O. Basat, A. M. Ugurlu, A. Aydın, and T. Aksan, “Digital artery perforator flaps: an easy and reliable choice for fingertip amputation reconstruction”, Acta Orthopaedica et Traumatologica Turcica, vol. 47, no. 4, pp. 250–254, 2013.
ISNAD Basat, Salih Onur et al. “Digital Artery Perforator Flaps: An Easy and Reliable Choice for Fingertip Amputation Reconstruction”. Acta Orthopaedica et Traumatologica Turcica 47/4 (September 2013), 250-254.
JAMA Basat SO, Ugurlu AM, Aydın A, Aksan T. Digital artery perforator flaps: an easy and reliable choice for fingertip amputation reconstruction. Acta Orthopaedica et Traumatologica Turcica. 2013;47:250–254.
MLA Basat, Salih Onur et al. “Digital Artery Perforator Flaps: An Easy and Reliable Choice for Fingertip Amputation Reconstruction”. Acta Orthopaedica Et Traumatologica Turcica, vol. 47, no. 4, 2013, pp. 250-4.
Vancouver Basat SO, Ugurlu AM, Aydın A, Aksan T. Digital artery perforator flaps: an easy and reliable choice for fingertip amputation reconstruction. Acta Orthopaedica et Traumatologica Turcica. 2013;47(4):250-4.