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Journal of the Korean Society for Surgery of the Hand 1997;2(1):47-55.
Published online January 1, 1997.
Reversed Cross Finger Subcutaneous Tissue Flap
Duke Whan Chung,Kang II Kim
역행성 교차 수지 피하조직 피판술
A skin defect with exposed tendons, bone, and joints with or without phalangeal fracture, sometimes can not be covered by skin graft. In many occasions, therefore, either cross finger flap or pedicled flap are frequently used as the choice of treatment. Most frequently used method of flaps are abdominal flap or distance flap. However, these method presents numerous problems including long duration of flapping time to gain revascularization, retaining in uncomfortable position for length of time, and the grafted tissue quality is functionally and cosmetically different to hand soft tissue. Thus, in minor loss of finger dorsum cases are usually treated using the traditional method of cross finger pedicle flap. However, this method frequently reported with a scar contracture around grafted tissue. Furthermore, if the donor site is around the joint area a limited phalangeal movement or cosmetically unsatisfied. On the other hand, the Reverse cross finger subcutaneous tissue flap method revealed a positive results and overcome the limitations reported in the traditional methods. Thus, in this report we would like to present the result and problems that we had experienced in the twelve reverse cross finger subcutaneous tissue flap cases. This study was conducted at Kyung-Hee University Hospital from 1992 and 1995. During the surgery. meticulous dissection technique of subcutaneous tissue is required and special precaution should made to not to damage donor's subdermal plexus. The best site for a donor is middle phalangeal or proximal phalangeal area and joint area should be avoid if possible.
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