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Arch Hand Microsurg > Volume 21(2); 2016 > Article
Journal of the Korean Society for Surgery of the Hand 2016;21(2):70-76.
Published online June 30, 2016.
DOI: https://doi.org/10.12790/jkssh.2016.21.2.70   
Reverse Digital Island Flap with Skin Strip Retention to Prevent Flap Congestion
Jin Yong Shin, Mun Young An, Si Gyun Roh, Nae Ho Lee, Kyung Moo Yang
Department of Plastic and Reconstructive Surgery, Chonbuk National University Hospital, Jeonju, Korea. psjyshin@gmail.com
Received: 4 April 2016   • Revised: 6 June 2016   • Accepted: 7 June 2016
Abstract
Purpose
The reverse digital island flap is useful for the repair of various fingertip injuries. We present a modified surgical technique with skin strip elevation for the prevention of postoperative congestion.

Methods
From January 2005 to October 2015, we performed 31 reconstructive procedures for finger injury using a reverse digital artery island flap with and without skin strip retention. Patients' clinical characteristics, surgical outcomes, and complications were investigated.

Results
All flaps survived and there were no donor site problems. The mean follow-up time was 5 months (range, 3-8 months). In skin strip retention group, mild venous congestion was observed in 1 case, although it resolved spontaneously. Another case retained flexion contracture, and 2 patients had stiffness at the distal interphalangeal joint. Whereas, in no retention group, venous congestion was observed in 3 cases, 1 patient had partial flap necrosis and 2 patient suffer in flexion contracture at metacarpophalangeal joint.

Conclusion
The reverse digital island flap procedure produces consistent results and is reliable for the treatment of fingertip injury. Our modified surgical technique of elevating the flap accompanied by skin strip retention helps prevent postoperative congestion.
 
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