Designing a dorsal branches flap of the proper palmar digital artery to repair pediatric middle-phalanx skin defects

Objective To discuss a design of flap of dorsal branches of the digital proper artery to repair pediatric middle phalanx skin defects and its effect. Methods From October, 2013 to March, 2015, antegrade flaps were used to treat 9 pediatric patients with skin defect in middle phalanx, the dorsal branches of the digital proper artery were used as the pedicel. The dorsal branch of digital proper nerve carried by flap was sutured with digital proper nerve in wound surface of middle phalanx, flap cutting area was 3.5 cm × 1.2 cm - 2.5 cm × 0.8 cm, the donor site of flap was repaired by full thickness skin graft. Results All the 9 flaps survived, and primary healing in the wound of donor and recipient site. The 9 patients were followed up for 6-12 months, with an average of 8 months. All the flaps had soft texture and full shape, the two-point discrimination was 5-9 mm, 6.5 mm on average. Conclusion To repair skin defect in the middle phalanx with flap using the dorsal branches of the digital proper artery as the pedicel and sutured the dorsal branch of digital proper nerve, combine advantages of the simplicity, high skin flap survival rate, good postoperative appearance and sensation recovery. Key words: Proper palmar digital artery, dorsal branches; Skin defects of the fingers; Children; Surgical flap; Microsurgical operation