We read with interest the article detailing the use of an expanded reverse-island
flap for entire digital reconstruction of the index and middle finger.
1
The use of reverse dorsal metacarpal artery island flaps (DMCA) was first described
by Maruyama in 1990 and has since been well documented in the literature.
- Lin M.
- Zuo X.
- He F.
- Fu Q.
- Li D.
- Zuo Z.
Clinical application of an expanded reverse-island flap with two dorsal metacarpal
arteries and dorsal metacarpal nerves in index- and middle-finger-degloving injury
repair and amputation reconstruction.
J Plast Reconstr Aesthetic Surg. 2023; 77 ([Available from: 〈https://linkinghub.elsevier.com/retrieve/pii/S1748681522006350〉]): 309-318
2
The indications for the DMCA flap have traditionally been reconstruction of dorsal
finger defects up to the distal phalanx and palmar finger defects up to the middle
phalanx
3
; however, this recent paper presents its use for entire digital reconstruction. We
feel there are major concerns in the study design and appropriate clinical application
of this flap. We have found the reverse island DMCA flap of use in narrow dorsal defects
of the digit up to the distal phalanx. Donor site closure is imperative in these flaps
to avoid an unsightly cosmetic appearance on the back of the hand, regardless of age.To read this article in full you will need to make a payment
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References
- Clinical application of an expanded reverse-island flap with two dorsal metacarpal arteries and dorsal metacarpal nerves in index- and middle-finger-degloving injury repair and amputation reconstruction.J Plast Reconstr Aesthetic Surg. 2023; 77 ([Available from: 〈https://linkinghub.elsevier.com/retrieve/pii/S1748681522006350〉]): 309-318
- The reverse dorsal metacarpal flap.Br J Plast Surg. 1990; 43: 24-27
- The retrograde approach to the reverse dorsal metacarpal artery flap.J Plast Reconstr Aesthetic Surg. 2021; 74: 1355-1401
- Dorsal metacarpal artery flap: an underrated workhorse flap for reconstruction of dorsal finger defects.Cureus. 2020; 12: e11251
Article info
Publication history
Published online: March 06, 2023
Accepted:
February 13,
2023
Received:
February 5,
2023
Identification
Copyright
© 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Clinical application of an expanded reverse-island flap with two dorsal metacarpal arteries and dorsal metacarpal nerves in index- and middle-finger-degloving injury repair and amputation reconstructionJournal of Plastic, Reconstructive & Aesthetic SurgeryVol. 77
- PreviewThe dorsal metacarpal artery flap (DMAF) is irrefutable as an effective way of repairing long finger defects, and hand surgeons might consider using it for long finger reconstruction or degloved injury repair. Unfortunately, the DMAF containing a single dorsal metacarpal artery (DMA) hinders the treatment effect. The sensory restoration of long fingers and the reconstruction of phalangeal joints and tendon grafts are unsolved challenges as well. We reported our experience in reconstructing the index and middle finger by a reverse-island flap with two DMAs and dorsal metacarpal nerves (DMNs) with blood supply.
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