Effects of simultaneous transplantation of multiple foot flaps in repairing defects of varying degrees on the palmar side of multiple fingers

Zhang Zhe; Li Muwei; Chen Zhiying; Huang Shaogeng; Liang Yong; Hu Wei; Wang Jianglong

doi:10.3760/cma.j.cn501225-20240514-00175

Volume 41 Issue 4

Apr. 2025

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Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > 2025 > 41(4): 394-400

Zhang Z,Li MW,Chen ZY,et al.Effects of simultaneous transplantation of multiple foot flaps in repairing defects of varying degrees on the palmar side of multiple fingers[J].Chin J Burns Wounds,2025,41(4):394-400.DOI: 10.3760/cma.j.cn501225-20240514-00175.

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Effects of simultaneous transplantation of multiple foot flaps in repairing defects of varying degrees on the palmar side of multiple fingers

doi: 10.3760/cma.j.cn501225-20240514-00175

Department of Hand Surgery, the Eighth People's Hospital of Longgang District (Longgang Orthopaedics Hospital of Shenzhen), Shenzhen 518116, China

Funds:

Longgang District Key Medical Specialty Construction Project 440307240221533600176

2023 Longgang District Medical and Health Science and Technology Project LGWJ2023-145

More Information

Corresponding author: Li Muwei, Email: 494995960@qq.com
Received Date: 2024-05-14

Abstract

Abstract

Objective To explore the effects of simultaneous transplantation of multiple foot flaps in repairing defects of varying degrees on the palmar side of multiple fingers. Methods This study was a retrospective observational study. From February 2020 to March 2023, 11 patients aged 23-52 years with defects on the palmar side of multiple fingers (with 38 affected fingers) meeting the inclusion criteria were hospitalized at Longgang Orthopedics Hospital of Shenzhen, including 8 males (with 31 affected fingers) and 3 females (with 7 affected fingers). All affected fingers sustained skin and soft tissue defects, along with exposed deep tissue such as finger bones and tendons, and 2 thumbs exhibited nail bed and distal phalanx defects. The defect area of each finger ranged from 1.5 cm×1.0 cm to 5.5 cm×3.0 cm. Foot flaps were designed based on the area and depth of the finger defects, and multiple foot flaps were transplanted simultaneously to repair the wounds of fingers. The area of single flap resected ranged from 2.0 cm×1.0 cm to 5.5 cm×3.0 cm. Donor site wounds were closed directly or covered using artificial dermis or split-thickness skin grafts. The number of resected flaps, the number of affected fingers repaired, and the surgical duration were recorded. The flap survival and foot donor site wound healing were observed postoperatively. The flap and donor and recipient sites recovery were observed during follow-up. At the final follow-up, the functional recovery of affected fingers was evaluated based on the trial criteria of the Chinese Medical Association's Hand Surgery Society for function evaluation of thumb and finger reconstruction, the sensory function of the flaps was assessed by the sensory function evaluation standard of the British Medical Research Council, the cold tolerance of the affected hands was evaluated with the Cold Intolerance Severity Scale, the scars at the recipient and donor sites were assessed using the Vancouver scar scale (VSS), and the function recovery of flap donor foot was evaluated with the Maryland Foot Score criteria. Results Donor sites were selected from 16 feet with 2-4 flaps harvested from each foot. Specifically, skin and soft tissue defects in 27 affected fingers were repaired using free lateral toe flaps, skin and soft tissue defects in 9 affected fingers were repaired using free medial foot flaps, and skin and soft tissue defects with finger bone defects in 2 affected fingers were repaired using free toenail osteocutaneous flaps. The surgical duration ranged from 5.60 to 9.25 hours. Postoperatively, all transplanted flaps in affected fingers survived, and all foot donor site wounds healed. Follow-up for 12-25 months showed that the appearance, color, and texture of the flaps were similar to the surrounding normal skin. The affected finger pulp was full with the fingertip having restored pain and touch sensation. There was no pain in the donor site of foot, and the walking ability of patients was not affected. At the final follow-up, the functional recovery was evaluated as excellent for 36 affected fingers and good for 2 affected fingers. The sensory function rating of the flaps was graded as S3-S4, and all affected fingers were mild intolerant to cold. VSS scores of the scars at the recipient sites ranged from 1-3, and VSS scores of the scars at the donor sites ranged from 1-5. The functional recovery of all flap donor feet was excellent. Conclusions Simultaneous transplantation of multiple foot flaps is an effective treatment method for repairing defects of varying degrees on the palmar side of multiple fingers, resulting in excellent aesthetic and functional recovery of the affected fingers while causing minimal damage to the donor site.
- Wounds and injuries,
- Foot,
- Fingers,
- Surgical flaps,
- Microsurgery,
- Free flap,
- Wound repair

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References(40)

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