title: [Repair of skin and soft tissue defects at distal end of finger and donor site with relaying reversed perforator flaps].
abstract: OBJECTIVE
  To explore the clinical effects of relaying reversed perforator flaps in repairing skin and soft tissue defects at distal end of finger and donor site.
  
  
  METHODS
  Seventeen patients (17 fingers) with skin and soft tissue defects at distal end of finger were hospitalized from June 2011 to June 2013. The reversed digital artery perforator flap with branch of digital nerve was used to repair the defect. The first donor site was repaired by dorsal metacarpal artery perforator flap; the second donor site was closed by suturing. The area of skin defect at distal end of finger ranged from 2.0 cm x 1.5 cm to 3.0 cm x 2.0 cm, and the area of digital artery perforator flap and dorsal metacarpal artery perforator flap ranged from 2.2 cm x 1.5 cm to 3.6 cm x 2.5 cm and 2.5 cm x 2.0 cm to 4.2 cm x 3.0 cm, respectively.
  
  
  RESULTS
  All the 34 flaps survived completely. Cyanosis and partial necrosis of the epidermis appeared in 1 flap, which was healed after dressing change. All the patients were followed up for 1 to 18 months, with mean time of 8 months. The color, texture and appearance of flaps were satisfactory. There was no depression or breakdown in the first donor sites. Some linear scars appeared in the second donor sites, but they did not affect the general appearance. The donor sites at joint or tendon did not affect the joint activity after healing. The results of function evaluation of range of active movement of the fingers were excellent in 15 cases and good in 2 cases. The results of sensation of the flaps were S3 in 1 finger, S4 in 2 fingers, and S5 in 14 fingers. The distance of two-point discrimination of flaps ranged from 5 to 7 mm, with mean distance of 6 mm.
  
  
  CONCLUSIONS
  Relaying reversed perforator flap, with reliable blood supply and both donor sites in the hand, can improve the appearance and function of the first donor site as well as repair skin and soft tissue defects at distal end of finger.
authors: Chengliang
authors: C
authors: Deng
authors: Zairong
authors: Z
authors: Wei
authors: Guangfeng
authors: G
authors: Sun
authors: Xiujun
authors: X
authors: Tang
authors: Wenhu
authors: W
authors: Jin
authors: Hai
authors: H
authors: Li
authors: Bihua
authors: B
authors: Wu
authors: Dali
authors: D
authors: Wang
mesh_terms: D002921:Cicatrix; D003863:Depression; D004817:Epidermis; D005121:Extremities; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D061525:Perforator Flap; D019651:Plastic Surgery Procedures / Q000379:methods*; D012867:Skin; D016038:Skin Transplantation / Q000379:methods*; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply; D013537:Sutures; D013710:Tendons; D016896:Treatment Outcome; D014945:Wound Healing