Free digital artery flap: an ideal flap for large finger defects in situations where local flaps are precluded.

The heterodigital arterialized flap is increasingly accepted as a flap of choice for reconstruction of large finger wounds. However, in situations where the adjacent fingers sustained concomitant injuries, the use of this flap as a local flap is precluded. This paper describes our experience with the free digital artery flap as an evolution of the heterodigital arterialized flap.

The spiral flap for fingertip resurfacing: short-term and long-term results.

Purpose: We describe a homodigital neurovascular island flap for reconstructing large pulp defects of the fingertips and review the short-term and long-term appearance and function of the reconstructed fingertips.

Methods: The spiral flap is a homodigital neurovascular island flap with a unique spiral advancement and transposition design that allows pulp reconstruction using sensate glabrous skin while restricting donor morbidity to the injured digit. Thirty-two fingertips were resurfaced using this flap.

Extending the reach of the heterodigital arterialized flap by cross-finger transfer.

Background: The heterodigital arterialized island flap is a versatile flap providing robust, vascularized, nonsensate soft-tissue cover for the reconstruction of sizable digital defects. Routine inclusion of a dorsal vein augments venous drainage and minimizes postoperative congestion. To extend the reach and versatility of the flap in resurfacing larger digital defects and defects in awkward areas such as the dorsal surface, distal fingertip, and far sides of border digits or thumb, a modification is proposed.