Useful Reconstruction Technique for Fingertip Necrosis Using Modified Louvre Flap: a Case Report

Abstract

Soft tissue reconstruction surgery for fingertip injuries is challenging, especially in cases with defects in multiple digits, presenting with serious complications. We present a case of circumflex defect due to necrosis in all fingertips that underwent reconstruction surgery by the modified Louvre flap without amputation. A 28-year-old woman, who underwent splenectomy 5 years previously for acquired idiopathic thrombocytopenic purpura and was under vaccination, developed distal fingertip skin and soft tissue defects with necrosis in the peripheral areas of all fingertips, owing to medications used to correct shock while in the ICU. Reconstruction was performed using the modified louvre flap technique. Flaps were designed sequentially for each of the fingers from the fifth finger to the thumb, according to the size and length of the digit. The patient received careful postoperative care involving wound dressings and prophylactic intravenous antibiotics, as well as a vasodilator and an anticoagulant for circulation and vascular augmentation, respectively. There were no signs of complications, such as infection or inflammation. Fingertip reconstruction was successful on all 5 fingers. We were able to successfully reconstruct the fingertip defects in all the circumflexed distal digits using the modified louvre flap technique customized to fit each finger.