Reconstruction of Fingertip Pulp Defect with Composite Graft

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Journal of the Korean Society for Surgery of the Hand 2006;11(1):25-30.
Published online March 1, 2006.

Jin Sik Burm, Soo Hyang Lee, Yang Woo Kim

복합조직이식술을 이용한 수지 첨부 수질부 결손의 재건

범진식, 이수향, 김양우

Abstract

The pulp defect of the fingertip should be reconstructed with the sufficient soft tissue, according to the depth and size of the defect. We reconstructed 13 fingertips of 11 patients with composite grafting from a mastoid area and/or an instep area of a sole. Six fingertips were acute pulp defects and seven were secondary deformities. In deep pulp defect, primary donor site was the mastoid area for coverage of thick compact tissue. If additional tissue supplement is necessary, composite grafting or skin grafting from the sole was performed secondarily. In broad pulp defect, the instep area of the sole was used for coverage of wide compact tissue. A composite graft consists of the fullthickness skin peripherally and the selectively localized fat-fascia tissues on a filling portion. Most of composite grafts survived completely without complications, except partial necrosis in one case. The skin-fat composite graft from the mastoid area and/or the instep area of the sole can provide sufficient soft tissue for padding, minimal donor site morbidity, and easy application in various shapes of the defect, thereby resulting in aesthetic and functional satisfaction.

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