Comparative Retrospective Analysis of Cross-Finger Flap Outcomes: A Study on Split-Thickness Skin Graft vs. Full-Thickness Skin Graft in Donor Fingers.

INTRODUCTION

Hand injuries, particularly those involving the fingers, are complex and often necessitate meticulous surgical interventions. Cross-finger flaps (CFFs) are a reliable technique for covering finger defects, with the choice of skin graft at the donor site playing a crucial role in the procedure's success. Split-thickness skin grafts (STSGs) and full-thickness skin grafts (FTSGs) are commonly used, each offering distinct advantages and drawbacks. This study compares the functional and aesthetic outcomes of donor fingers covered with STSG versus FTSG in CFF procedures.

MATERIALS AND METHODS

This retrospective observational study was conducted from January 2020 to 2024. A total of 82 patients who underwent CFF surgery were included, with 41 patients each in Group A (STSG) and Group B (FTSG). The functional and aesthetic outcomes were assessed. Statistical analysis was performed using SPSS version 26.0 (IBM Corp., Armonk, NY), with significance set at p < 0.05.

RESULTS

The study revealed that Group B had superior outcomes across all measured parameters. The mean visual analog scale (VAS) score for aesthetic outcomes was significantly higher in Group B (8.5 ± 1.2) compared to Group A (7.0 ± 1.5, p < 0.01). Functional recovery in proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints, measured by range of motion, was also better in Group B compared to Group A (p = 0.002). Sensory recovery was more favorable in Group B, with 85% achieving S3+ or better, compared to 60% in Group A (p < 0.05). Additionally, the graft donor site scar was significantly less noticeable in Group B, with a Vancouver Scar Scale score of 3.5 ± 1.1, compared to 5.0 ± 1.4 in Group A (p < 0.01).

CONCLUSION

FTSG offers superior functional and aesthetic outcomes compared to STSG in this study. The findings suggest that FTSG should be preferred for covering donor fingers. These results provide strong evidence for the use of FTSG in optimizing surgical outcomes and improving patient satisfaction.