Affiliation:
1. Department of Hand and Foot Surgery, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University
2. Division of Plastic Surgery, Sacred Heart Campus, St. Luke’s Hospital
3. Department of Orthopedic Surgery, University of Pennsylvania
4. Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University College of Medicine.
Abstract
Background:
Although palmar and digital soft-tissue resurfacing with intrinsic flaps may provide functional and aesthetic reconstruction, the donor site may result in a tight closure or need for a skin graft once the flap is raised. In this series, the “mini-shaped kiss flap” was used to increase the resurfacing efficiency and preserve hand function.
Methods:
The mini-shaped kiss flaps, based on common palmar digital arteries (eg, princeps pollicis artery and ulnar palmar digital artery), were developed for the resurfacing of distal or proximal finger areas. The tiny skin paddles were “kissed” together and transferred as pedicled in proposed dimensions and shape. The flap size, donor/recipient site, perforator source, whether free or pedicled, surgical outcome, and donor-site morbidity were evaluated.
Results:
Twenty mini-shaped kiss flaps were harvested for the purpose of palmar and digital resurfacing. The flap sizes varied from 3 × 1.2 cm to 5 × 2 cm. All 19 patients, aged 6 to 52 years (mean, 35 years), achieved successful reconstruction without major complications after 6- to 12-month follow-up.
Conclusions:
The mini-shaped kiss flap technique exhibited favorable surgical outcomes with excellent color and texture match to the recipient sites. The reverse midpalm, thenar, and hypothenar island flap can be raised at the cost of an unnoticeable linear scar with minimized functional compromise in the donor area.
CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Publisher
Ovid Technologies (Wolters Kluwer Health)