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Journal of the Korean Society for Surgery of the Hand 1998;3(2):237-248.
Published online January 1, 1998.
Reconstruction of Soft Tissue Hand Defects Using Various Skin Free Flaps from the Foot
Hyo Heon Kim,Sang Hyun Woo,Jung Hyun Seul
수부 재피복을 위한 유리피판의 공여부로서 족부의 이용
To reconstruct a the soft-tissue defect of the hand, the thickness sensation, texture and function of the skin free flap must be considered. Surgeons can select many parts of the body as a donor site for the flap. It is ideal to use the foot having the anatomical characteristics most similar to the original tissue. The purpose of this study is to report clinical applications of free flaps from the foot for hand reconstruction. We used 37 cases of skin free flaps from the foot which were composed of the dorsalis pedis flap (18), first web space flap (7), medial plantar flap (4), and pulp flap (8). The dorsalis pedis free flap was used in the soft tissue defect due to hand dorsum injury (12). It was also used in the tendocutaneous free flap after the removal of squamous cell carcinoma of hand dorsum (3). The first web space flaps released severe contractures of the first web space created after severe hand injuries. They also filled up the space that the tissue defect result in. The lateral skin of the great toe was the most ideal donor site because it can offer the sensation and durability for reconstruction of the pulp defect of the finger. There was a demerit that flap dissection was difficult due to a severe anatomical variation of the dorsalis pedis artery and first dorsal metatarsal artery and some scars were found after skin graft exposure on the foot dorsum. And there was a disadvantage that the region to have the skin graft had poor hygiene though the first web space and the pulp were not exposed. But it is considered that it will be the most appropriate in the reconstruction of the hand since it has the merit to obtain thickness, sense, and durability as the most similar tissue. It is also to assess donor site problems as well as anatomical variations of vessels of the flaps.

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