A Modification to Enhance the Survival of the Island FDMA Flap by Adding a Skin Bridge

<h3>Background</h3><p dir="ltr">Distal thumb injuries are common in high construction load regions, and it is a challenging task for the plastic surgeon to find the optimum choice that preserves thumb length and provides a sensory substitute to the lost tissue. Introducin...

Full description

Saved in:
Bibliographic Details
Main Author: Salim Al Lahham (16515333) (author)
Other Authors: Mohamed Badie Ahmed (16515335) (author), Ghanem Aljassem (16515336) (author), Ruba Sada (16515339) (author), Zaki T. N. Alyazji (16515342) (author), Jimmy Thomas (16515354) (author)
Published: 2021
Subjects:
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1864513563356299264
author Salim Al Lahham (16515333)
author2 Mohamed Badie Ahmed (16515335)
Ghanem Aljassem (16515336)
Ruba Sada (16515339)
Zaki T. N. Alyazji (16515342)
Jimmy Thomas (16515354)
author2_role author
author
author
author
author
author_facet Salim Al Lahham (16515333)
Mohamed Badie Ahmed (16515335)
Ghanem Aljassem (16515336)
Ruba Sada (16515339)
Zaki T. N. Alyazji (16515342)
Jimmy Thomas (16515354)
author_role author
dc.creator.none.fl_str_mv Salim Al Lahham (16515333)
Mohamed Badie Ahmed (16515335)
Ghanem Aljassem (16515336)
Ruba Sada (16515339)
Zaki T. N. Alyazji (16515342)
Jimmy Thomas (16515354)
dc.date.none.fl_str_mv 2021-02-17T12:00:00Z
dc.identifier.none.fl_str_mv 10.1097/gox.0000000000003434
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/A_Modification_to_Enhance_the_Survival_of_the_Island_FDMA_Flap_by_Adding_a_Skin_Bridge/23650494
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Surgery
Reconstructive surgery
Distal thumb injuries
Injuries
Kite flap
Foucher's flap
Second dorsal metacarpal artery
dc.title.none.fl_str_mv A Modification to Enhance the Survival of the Island FDMA Flap by Adding a Skin Bridge
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Background</h3><p dir="ltr">Distal thumb injuries are common in high construction load regions, and it is a challenging task for the plastic surgeon to find the optimum choice that preserves thumb length and provides a sensory substitute to the lost tissue. Introducing first dorsal metacarpal artery flap has solved the dilemma. One drawback is that the flap is susceptible to distal necrosis, which can happen because of tight tunneling or insufficient venous drainage. We combined Foucher and Holevich characteristics to design a flap that promises to solve the problem.</p><h3>Methods</h3><p dir="ltr">This is a case series that includes 9 patients where we describe a technique that has the potential to enhance the survival of the first dorsal metacarpal artery (FDMA) flap and decreases the rate of distal necrosis via addition of a 5-mm skin bridge to the pedicle and by avoiding tunneling. Distal necrosis of the patients in this study patients was compared with that in a control of 10 patients in whom we did the conventional FDMA flap. Patients were followed for 6 weeks to trace early postoperative complications (infection, dehiscence, and necrosis) and the establishment of protective sensation (pain and temperature).</p><h3>Results</h3><p dir="ltr">None of our patients had distal necrosis, infection, or dehiscence, and all had protective sensation in the flap. In comparison, 4 patients in the control group developed distal necrosis.</p><h3>Conclusion</h3><p dir="ltr">FDMA is one of the best choices when it comes to distal thumb reconstruction, but it has the disadvantage of distal necrosis, which might be avoided when using the technique mentioned in this study.</p><h2>Other Information</h2><p dir="ltr">Published in: Plastic and Reconstructive Surgery - Global Open<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="http://dx.doi.org/10.1097/gox.0000000000003434" target="_blank">http://dx.doi.org/10.1097/gox.0000000000003434</a><br><a href="https://creativecommons.org/licenses/by/4.0/" target="_blank"></a><a href="http://dx.doi.org/10.1097/gox.0000000000003434" target="_blank"></a></p>
eu_rights_str_mv openAccess
id Manara2_2bd0fad8dbd7888d69b6ffa05764c58d
identifier_str_mv 10.1097/gox.0000000000003434
network_acronym_str Manara2
network_name_str Manara2
oai_identifier_str oai:figshare.com:article/23650494
publishDate 2021
repository.mail.fl_str_mv
repository.name.fl_str_mv
repository_id_str
rights_invalid_str_mv CC BY 4.0
spelling A Modification to Enhance the Survival of the Island FDMA Flap by Adding a Skin BridgeSalim Al Lahham (16515333)Mohamed Badie Ahmed (16515335)Ghanem Aljassem (16515336)Ruba Sada (16515339)Zaki T. N. Alyazji (16515342)Jimmy Thomas (16515354)Biomedical and clinical sciencesClinical sciencesSurgeryReconstructive surgeryDistal thumb injuriesInjuriesKite flapFoucher's flapSecond dorsal metacarpal artery<h3>Background</h3><p dir="ltr">Distal thumb injuries are common in high construction load regions, and it is a challenging task for the plastic surgeon to find the optimum choice that preserves thumb length and provides a sensory substitute to the lost tissue. Introducing first dorsal metacarpal artery flap has solved the dilemma. One drawback is that the flap is susceptible to distal necrosis, which can happen because of tight tunneling or insufficient venous drainage. We combined Foucher and Holevich characteristics to design a flap that promises to solve the problem.</p><h3>Methods</h3><p dir="ltr">This is a case series that includes 9 patients where we describe a technique that has the potential to enhance the survival of the first dorsal metacarpal artery (FDMA) flap and decreases the rate of distal necrosis via addition of a 5-mm skin bridge to the pedicle and by avoiding tunneling. Distal necrosis of the patients in this study patients was compared with that in a control of 10 patients in whom we did the conventional FDMA flap. Patients were followed for 6 weeks to trace early postoperative complications (infection, dehiscence, and necrosis) and the establishment of protective sensation (pain and temperature).</p><h3>Results</h3><p dir="ltr">None of our patients had distal necrosis, infection, or dehiscence, and all had protective sensation in the flap. In comparison, 4 patients in the control group developed distal necrosis.</p><h3>Conclusion</h3><p dir="ltr">FDMA is one of the best choices when it comes to distal thumb reconstruction, but it has the disadvantage of distal necrosis, which might be avoided when using the technique mentioned in this study.</p><h2>Other Information</h2><p dir="ltr">Published in: Plastic and Reconstructive Surgery - Global Open<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="http://dx.doi.org/10.1097/gox.0000000000003434" target="_blank">http://dx.doi.org/10.1097/gox.0000000000003434</a><br><a href="https://creativecommons.org/licenses/by/4.0/" target="_blank"></a><a href="http://dx.doi.org/10.1097/gox.0000000000003434" target="_blank"></a></p>2021-02-17T12:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1097/gox.0000000000003434https://figshare.com/articles/journal_contribution/A_Modification_to_Enhance_the_Survival_of_the_Island_FDMA_Flap_by_Adding_a_Skin_Bridge/23650494CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/236504942021-02-17T12:00:00Z
spellingShingle A Modification to Enhance the Survival of the Island FDMA Flap by Adding a Skin Bridge
Salim Al Lahham (16515333)
Biomedical and clinical sciences
Clinical sciences
Surgery
Reconstructive surgery
Distal thumb injuries
Injuries
Kite flap
Foucher's flap
Second dorsal metacarpal artery
status_str publishedVersion
title A Modification to Enhance the Survival of the Island FDMA Flap by Adding a Skin Bridge
title_full A Modification to Enhance the Survival of the Island FDMA Flap by Adding a Skin Bridge
title_fullStr A Modification to Enhance the Survival of the Island FDMA Flap by Adding a Skin Bridge
title_full_unstemmed A Modification to Enhance the Survival of the Island FDMA Flap by Adding a Skin Bridge
title_short A Modification to Enhance the Survival of the Island FDMA Flap by Adding a Skin Bridge
title_sort A Modification to Enhance the Survival of the Island FDMA Flap by Adding a Skin Bridge
topic Biomedical and clinical sciences
Clinical sciences
Surgery
Reconstructive surgery
Distal thumb injuries
Injuries
Kite flap
Foucher's flap
Second dorsal metacarpal artery