Reconstruction of Finger Pulp Defects

Abstract

The finger pulp defect of thumb and other fingers is common in clinic, which affects the integrity of fingertip and the holding function. Traditional local flaps, reverse flaps, and free flaps can all be used to repair the wound surface, but the function and appearance are difficult to satisfy patients. The reason is that the finger pulp has its special structure: the skin surface of the finger pulp has a large number of fine skin lines; the dermis of the finger pulp is composed of dense connective tissue; the deep dermis of the finger pulp is closely connected with the subcutaneous tissue, and the deep subcutaneous fat tissue is separated by many vertical fiber bundles which attach to the deep fascia. Therefore, when the finger pulp is to be reconstructed, the above structures need to be reconstructed. Obviously, only the toe pulp is the ideal donor site. At present, the commonly used donor sites in clinical practice include fibular flap of the great toe and tibial flap of the second toe. The former one has larger soft tissue volume, and the donor site is easy to be sutured directly which is focused on in this chapter.