Photo Credit: kdrkara
The following is a summary of “Results of innervated digital artery perforator flap and direct-flow homodigital flap application in fingertip soft tissue amputations,” published in the October 2024 issue of Surgery by Atilgan et al.
Fingertip amputations are typical in hand injuries, and reconstruction methods like the innervated digital artery perforator (IDAP) flap and direct-flow homodigital flap are used to restore function and appearance.
Researchers conducted a retrospective study comparing outcomes between the IDAP and direct-flow homodigital flap in fingertip soft tissue amputations.
They reviewed 32 patients (26 men, 6 women; mean age 28.72 ± 11.5 years) treated (2020 and 2022), with 14 undergoing IDAP flap and 18 receiving direct-flow homodigital flap. Parameters such as defect size, cold intolerance, venous congestion, hand function (Sollerman score), sensory recovery (Seddon test), static two-point discrimination (s2PD), and complications were assessed.
The results showed that the homodigital group had higher postoperative Sollerman hand function scores (75 ± 2.64) than the IDAP group (73 ± 3.34). The mean area of tissue loss was 2.70 ± 1.37 cm2, and s2PD averaged 4.94 ± 1.04 mm. Sensory recovery was slightly better in the IDAP group with Seddon sensory test results of S4 (57.9%), S3+ (21.1%), and S3 (21.1%) compared to the homodigital group with S4 (61.5%), S3 (23.1%), S3+ (7.7%), and S2 (7.7%). Complications occurred in 5 patients, but no flap loss or revisions were required. Statistical significance was not achieved (P>0.05).
They concluded that although the IDAP flap may provide better sensory recovery, both methods yield good functional outcomes for fingertip amputation reconstruction.
Source: bmcsurg.biomedcentral.com/articles/10.1186/s12893-024-02617-7
