title: Vascularized Partial Free Toe Tissue Transfer Under Local Anesthesia.
abstract: BACKGROUND
  This study was designed to introduce free toe soft tissue transfer using local infiltration anesthesia in patients not suitable for general anesthesia and local tissue coverage.
  
  
  METHODS
  From January 2006 to August 2012, a total of 11 traumatic fingertip defects were reconstructed by toe soft tissue transfer. All procedures except 1 were done as primary reconstructions, with either the lateral side of the great toe (5 cases) or the medial side of the second toe (6 cases) used as a donor. Postoperative follow-up periods were between 8 months to 2 years and 6 months.
  
  
  RESULTS
  Flap sizes varied from 1.0 × 2.0 to 2.0 × 3.5 cm. The mean operative times were 4 hours 29 minutes for cases done by a single team and 3 hours 21 minutes for cases done by a 2-team approach. Approximately 5.8 mL of local anesthetic agent was used in each finger and 5.9 mL was used in the toes for a total of 11.7 mL. All flaps survived and were fully taken without complications, except 1 case that presented partial necrosis.
  
  
  CONCLUSIONS
  Fingertip soft tissue reconstruction by free toe tissue transfer under local anesthesia uses a more limited operative field, with a shorter operative time, enabling reconstruction in patients not suitable for general anesthesia. This is even more so with a microsurgical 2-team approach, which reduces the volume of anesthetic agent needed, making this method a sufficiently realistic option for fingertip soft tissue reconstruction.
authors.affiliation: From the Department of Plastic and Reconstructive Surgery, Anam Hospital, College of Medicine, Korea University, Seoul, Republic of Korea.
authors.forename: Hyon-Surk
authors.initials: HS
authors.lastname: Kim
authors.forename: Tae-Won
authors.initials: TW
authors.lastname: Jeong
authors.forename: Seung-Ha
authors.initials: SH
authors.lastname: Park
authors.forename: Byung-Il
authors.initials: BI
authors.lastname: Lee
mesh_terms: D000328:Adult; D000772:Anesthesia, Local; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000637:transplantation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D014034:Toes / Q000637:transplantation*; D016896:Treatment Outcome