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KMID : 0603120120210020153
Journal of the Korean Microsurgical Society
2012 Volume.21 No. 2 p.153 ~ p.158
The First Web Space Free Flap of the Foot to Reconstruct the Pulp of Fingers
Kong Byeong-Seon

Kim Yun-Seok
Lee Hyeong-Seok
Jung Dae-Won
Kwak Jae-Yong
Lee Hyun-Suk
Abstract
Purpose: The first web space of the foot has a similar thickness and skin texture of the pulp of the fingers. Moreover, it has a reliable blood vessel and sensory nerve. The purpose of this study was to evaluate the clinical results of the first web space free flap to reconstruct the pulp of fingers.

Materials and Methods: Authors have performed 23 cases of first web space free flap to reconstruct the pulp defect of the fingers between June 2004 and May 2009. The age of the patients ranged from 20years old to 55 years old. The size of the flap ranged from 1x1.5 cm to 8.5x2.5 cm. The mean flap area was 5.4 cm2. In 4 cases, we elevated the flap including lateral aspect of the big toe and medial aspect of the second toe. And then we made an artificial syndactyly to reconstruct the pulps on two fingers at the same time. In all cases, we performed 1 digital artery and 1 dorsal vein anastomosis. Every donor site that had a small defect healed spontaneously without any additional operations to cover it.

Results: Of this type of surgery 21 flaps (91.3%) survived, 2 flaps (8.7%) failed. There was no severe complication in the donor sites. There was no walking disturbance due to the skin defect of the donor site. The static 2 point discrimination in 11 cases that we could check ranged from 3 mm to 15 mm.

Conclusion: The authors believe that the first web space free flap of the foot is a good option for the reconstruction of the pulp of the fingers and it has a minimal donor site morbidity.
KEYWORD
Pulp, First web sapce free flap
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