Resurfacing the complex finger defect and sensation reconstruction with the free distal ulnar artery perforator flap: a self-controlled case series study

Ann Transl Med. 2022 May;10(10):543. doi: 10.21037/atm-22-1975.

Abstract

Background: The purpose of this clinical research is to report our results using the free distal ulnar artery perforator flap for resurfacing complex tissue defects in the finger, and to provide empirical reference for the treatment of subsequent clinical cases.

Methods: In our research, eight patients with complex skin defects were treated with free distal ulnar artery perforator flaps. There were 4 index, 3 long, and 2 ring fingers. All the flaps were raised from the ipsilateral ulnar lateral wrist. The donor sites were covered with a full thickness skin graft or closed by direct suture.

Results: Comprehensive analysis of the clinical treatment process of eight patients, all flaps survived completely without any necrosis during the 6-18 months follow-up. The patients were satisfied with the finger mobility, the sensation function, and the aesthetic appearance.

Conclusions: Resurfacing complex tissue defects in the finger using the free perforator flap in a single stage, especially when the defect is medium in size and accompanied by digit nerve loss, is a valuable technique to achieve satisfaction in both sensation and aesthetic appearance. The ulnar artery perforator flap seems to be a reliable and flexible flap for addressing complex hand injuries with tissue loss.

Keywords: Hand injury; digit nerve defect; distal ulnar artery; perforator flap.