Modified free flap based on the descending branch of ulnar artery above-wrist cutaneous branch for coverage of soft tissue defect of the finger

Objective To investigate the feasibility of a modified technique of harvesting the flap based on the descending branch of ulnar artery above-wrist cutaneous branch and evaluate its clinical results in repairing soft tissue defect of the fingers.Methods From November 2008 to November 2011,30 patients with soft tissue defect of the fingers were treated with the above mentioned flap.The modified method was to design the flap based on the precise projection of ulnar artery above-wrist cutaneous branch.Part of the ulnar artery was also included in the vascular pedicle for blood vessel anastomosis.The area of the flaps ranged from 2.0 cm × 4 cm to 4.5 cm × 7.0 cm.Results Complete survival was achieved in 29 flaps uneventfully.Distal necrosis occurred in 1 flap,which was managed by debridement and skin graft.Secondary flap plasty was done in 2 cases.Postoperative follow-up period ranged from 6 to 24 months.The outcomes were graded as excellent in 27 cases,good in 2 cases,fair in 1 case according to the functional assessment criteria for upper extremities issued by the Hand Society of the Chinese Medical Association,achieving a 96.6％ good and excellent rate.Two-point discrimination of the flaps was 8 to 12 mm.Conclusion The flap based on the descending branch of ulnar artery above-wrist cutaneous branch can be used satisfactorily to repair soft tissue defect of the finger.The modified method can effectively improve the safety of the procedure,which is beneficial to the promotion of use of the flap. Key words: Surgical flaps;  Finger injuries;  Ulnar artery