title: Temporary Ectopic Implantation of a Single Finger Using a Perforator as a Feeding Vessel, and Subsequent Prefabricated Chimeric Flap Transplantation.
abstract: OBJECTIVE
  Ectopic implantation was first reported by Godina in 1986. We herein present 2 cases in which amputated fingers were salvaged and reconstructed by means of temporary ectopic implantation utilizing perforator anastomoses and chimeric flaps.
  
  
  METHODS
  Case 1. A 30-year-old man injured his right hand. All of the fingers were completely crushed with the exception of the little finger. We performed an ectopic implantation by using the superficial circumflex iliac artery perforator. Three months later, the little finger was transplanted with the superficial circumflex iliac artery perforator flap, vascularized nerve, and the 2nd metacarpal bone. Case 2. A 29-year-old man suffered a degloving injury of the index finger. The digital artery was anastomosed to deep inferior epigastric artery perforator. One month later, a deep inferior epigastric artery perforator flap containing the ectopically transplanted index finger was transplanted, but the index fingertip became pale and necrotized. After debridement, a hemipulp transplantation was performed.
  
  
  CONCLUSIONS
  As the diameter of perforators is similar to that of digital arteries, and perforators are capable of supplying large areas of tissue, they can be used as recipient vessels for ectopic implantation in finger salvage procedures. Another advantage of perforators as feeding vessels in ectopic implantation is the possibility of forming an ectopic chimera; the finger can be incorporated as a part of the chimeric reconstructive flap. With respect to these advantages, the perforator can be used as a feeder in an ectopic implantation of single finger.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
authors.forename: Narushima
authors.initials: N
authors.lastname: Mitsunaga
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
authors.forename: Yamamoto
authors.initials: Y
authors.lastname: Takumi
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
authors.forename: Hara
authors.initials: H
authors.lastname: Hisako
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
authors.forename: Yamamoto
authors.initials: Y
authors.lastname: Yusuke
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
authors.forename: Oshima
authors.initials: O
authors.lastname: Azusa
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
authors.forename: Kikuchi
authors.initials: K
authors.lastname: Kazuki
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
authors.forename: Kato
authors.initials: K
authors.lastname: Harunosuke
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
authors.forename: Sata
authors.initials: S
authors.lastname: Kumiko
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
authors.forename: Doi
authors.initials: D
authors.lastname: Kentaro
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
authors.forename: Todokoro
authors.initials: T
authors.lastname: Takeshi
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
authors.forename: Araki
authors.initials: A
authors.lastname: Jun
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
authors.forename: Mihara
authors.initials: M
authors.lastname: Makoto
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
authors.forename: Higashino
authors.initials: H
authors.lastname: Takuya
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
authors.forename: Iida
authors.initials: I
authors.lastname: Takuya
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
authors.forename: Koshima
authors.initials: K
authors.lastname: Isao