Kodaira Satoshi, Fukumoto Keizo
Saitama Hand and Microsurgery Institute, Saitama Jikei Hospital, 3-208 Ishiwara, Kumagaya City, Saitama, 360-0816, Japan.
J Hand Microsurg. 2024 Aug 9;16(5):100144. doi: 10.1016/j.jham.2024.100144. eCollection 2024 Dec.
The digital artery perforator (DAP) flap is used to repair finger pulp defects as it can help preserve the digital artery. The standard DAP flap donor site is dorsal or lateral; however, the color of the flap typically poorly matches that of the finger pulp. The purpose of this study is to report two types of novel palmar DAP flaps.
We designed two types of palmar DAP flaps using a digital artery perforator at the lateral base of the finger pulp and used them to reconstruct eight fingers of seven patients. The type A flap was created on the palmar lateral aspect of the middle phalanx and was rotated by 90°; it was used in combination with an oblique triangular flap for four small defects. The type B flap was created on the palmar aspect of the middle phalanx and was rotated by 180°; it was used in combination with skin grafts for four moderate defects.
All flaps survived completely despite transient congestion with the type B flap within 3 days of surgery.
Since this perforator is always present, the DAP flap is useful and yields esthetically pleasing results.
指动脉穿支（DAP）皮瓣可保留指动脉，常用于修复指腹缺损。标准的DAP皮瓣供区位于手背或手外侧；然而，皮瓣颜色通常与指腹不匹配。本研究旨在报告两种新型手掌DAP皮瓣。
我们利用指腹外侧基部的指动脉穿支设计了两种手掌DAP皮瓣，并用于重建7例患者的8根手指。A型皮瓣取自中节指骨掌侧外侧，旋转90°；用于修复4例小面积缺损，并联合斜三角形皮瓣。B型皮瓣取自中节指骨掌侧，旋转180°；用于修复4例中等面积缺损，并联合植皮。
所有皮瓣均完全成活，尽管B型皮瓣在术后3天内出现短暂淤血。
由于该穿支始终存在，DAP皮瓣实用且美观效果良好。
