Repair of perforating skin and soft tissue defects of the palms with dorsalis pedis parallel flaps

Objective To explore the effect of dorsalis pedis parallel flaps in repairing perforating skin and soft tissue defects of the palms. Methods Eighteen patients with perforating skin and soft tissue defects of the palms were hospitalized from July 2008 to November 2010. The area of skin defect ranged from 2.0 cm×1.5 cm to 5.0 cm×2.5 cm. The dorsalis pedis parallel flaps were used to repair these defects, with the area ranging from 2.0 cm×2.0 cm to 5.5 cm×3.0 cm. The donor sites were covered with autologous full-thickness skin from inner thigh. Results All the 18 flaps and skin grafts of donor sites survived completely. Seventeen patients were followed up for 6 to 23 months, with mean time of 10 months, and one patient was lost to follow-up. The texture, elasticity, and appearance of all the 17 flaps were satisfactory, with no obvious pigmentation or cicatricial contracture. At the last follow-up, the distance of two-point discrimination of flaps ranged from 6 to 9 mm, with mean distance of 7.4 mm, and the sensation of flaps reached S3 in 13 patients who had nerve anastomosis. Conclusions The dorsalis pedis parallel flap, with reliable blood supply and flexible design, is a good choice for repairing perforating skin and soft tissue defects of the palms.