title: Application of the dorsal metacarpal artery perforator flap for resurfacing soft-tissue defects proximal to the fingertip.
abstract: BACKGROUND
  The dorsal metacarpal artery perforator flap is a versatile solution for resurfacing soft-tissue defects of fingers. The authors present their experience in applying this flap for a variety of finger wounds for which conventional means may not be amenable.
  
  
  METHODS
  Fifty-eight dorsal metacarpal artery perforator flaps were used to resurface 60 finger soft-tissue defects in 56 patients over a 5-year period. Fifty-two patients were men and their average age was 37 years. This flap was used to reconstruct soft-tissue defects after débridement of infected wounds in 28 patients, traumatic wounds in 26 patients, and electrical burns in two patients.
  
  
  RESULTS
  The average flap size was 4.6 × 2.3 cm; 34 flaps were based on the second dorsal metacarpal artery perforator, 14 were based on the third dorsal metacarpal artery perforator, and 10 were based on the fourth dorsal metacarpal artery perforator. Twenty-one flaps were used to resurface defects distal to the proximal interphalangeal joint, and 37 flaps were used to resurface defects over the proximal interphalangeal joint and proximal to it. Skin grafting was needed to close the donor defect in seven patients. Complications included venous congestion in six flaps and arterial insufficiency in three flaps, with total loss of two flaps and infection in one case.
  
  
  CONCLUSIONS
  The dorsal metacarpal artery perforator flap is a thin, pliable flap that is simple to raise, has minimal donor-site morbidity, and can reliably cover soft-tissue defects up to the proximal half of the middle phalanx.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Singapore; Tokyo, Japan; and Ann Arbor, Mich. From the Department of Hand and Reconstructive Microsurgery, National University Health System; the Department of Plastic, Reconstructive, and Aesthetic Surgery, Nippon Medical School; and the Section of Plastic Surgery, Department of Surgery, University of Michigan Health System.
authors.forename: Sandeep J
authors.initials: SJ
authors.lastname: Sebastin
authors.forename: Romina T
authors.initials: RT
authors.lastname: Mendoza
authors.forename: Alphonsus K S
authors.initials: AKS
authors.lastname: Chong
authors.forename: Yeong P
authors.initials: YP
authors.lastname: Peng
authors.forename: Shimpei
authors.initials: S
authors.lastname: Ono
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Chung
authors.forename: Aymeric Y T
authors.initials: AYT
authors.lastname: Lim
mesh_terms: D000328:Adult; D001158:Arteries / Q000601:surgery; D002058:Burns, Electric / Q000601:surgery; D003646:Debridement; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*; D020858:Tissue and Organ Harvesting / Q000379:methods; D014946:Wound Infection / Q000601:surgery