title: Clinical experience of multiple flaps for the reconstruction of dorsal digital defects.
abstract: OBJECTIVE
  In this report, we present our experience with reconstruction of the skin defects on the dorsum of the digits using multiple flaps.
  
  
  METHODS
  Between November 2010 and March 2013, 45 patients with dorsal digital defects underwent reconstruction using homodigital dorsal digital fasciocutaneous flap (n = 17), heterodigital dorsal digital fasciocutaneous flap (n = 14), dorsal metacarpal artery fasciocutaneous flap (n = 8) and free venous flaps (n = 6). The average flap size was 1.5 × 1.5 cm to 2.0 × 2.5 cm. Donor sites were covered with full-thickness skin graft.
  
  
  RESULTS
  All flaps survived completely and the donor sites healed without complications. The mean follow-up period was 18 weeks. During the follow up period, 7 patients treated with reverse homodigital fasciocutaneous flaps developed swelling in the distal portion of flaps, 3 patients treated with reverse dorsal metacarpal artery fasciocutaneous flaps developed mild swelling in the distal portion of flaps but survive well, and 4 patients treated with free venous flaps experienced venous congestion. Of the 14 patients treated with heterodigital fasciocutaneous flaps, there were 11 cases with a retrograde pedicle and 3 cases with a direct pedicle. No full-thickness graft necrosis was noted.
  
  
  CONCLUSIONS
  Multiple options are available for the repair of skin defects on the dorsum of the digits. Besides, the use of a heterodigital fasciocutaneous flap was a simple, safe, and less invasive regimen for repairing dorsal digital skin defects.
authors.affiliation: The Hand Surgery Center of Chinese People's Liberation Army, The 401st Hospital of CPLA Qingdao, P. R. China.
authors.forename: Hongsheng
authors.initials: H
authors.lastname: Jiao
authors.affiliation: The Hand Surgery Center of Chinese People's Liberation Army, The 401st Hospital of CPLA Qingdao, P. R. China.
authors.forename: Xiaoheng
authors.initials: X
authors.lastname: Ding
authors.affiliation: The Hand Surgery Center of Chinese People's Liberation Army, The 401st Hospital of CPLA Qingdao, P. R. China.
authors.forename: Yujie
authors.initials: Y
authors.lastname: Liu
authors.affiliation: The Hand Surgery Center of Chinese People's Liberation Army, The 401st Hospital of CPLA Qingdao, P. R. China.
authors.forename: Hongxun
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Orthopedic and Traumatic Surgery, General Hospital of Jinan Military Command Jinan, P. R. China.
authors.forename: Xuecheng
authors.initials: X
authors.lastname: Cao
keywords: Dorsal digital defects; dorsal digital fasciocutaneous flap; finger; free venous flap; microsurgery