title: Postoperative voluminal flap reduction after fingertip reconstruction using the reverse digital artery island flap.
abstract: A total of 16 fingers of 16 patients were subjected to fingertip reconstruction using the reverse digital artery island flap (RDAIF). We evaluated the influences of postoperative flap congestion, initial harvested flap size, patient's age and smoking habit on postoperative final flap size and postoperative range of total active motion (TAM) in affected fingers at a mean interval of 11.4 months. In the results, final flap size and TAM showed a tendency to decrease with increase in the initial harvested flap size and age. Eventually, the final flap size moved towards the size of the fingertip defect. Factors of flap congestion and smoking habit had little influence on the change in flap size and TAM. In conclusion, wide harvested flaps showed significant postoperative reduction in size compared with the small flaps, and extensive skin defect after flap harvest caused a decrease in postoperative TAM. Thus, the size of the harvested RDAIF should be comparable to that of the fingertip defect to prevent postoperative decrease in range of motion in affected fingers, and indication of this flap to the elderly needs to be considered.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Science, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Usami
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kodaira
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Homma
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Okazaki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013524:Surgical Flaps / Q000098:blood supply*; D016896:Treatment Outcome
keywords: Fingertip Reconstruction; Flap Atrophy; Flap Reduction; Reverse Flap