THE HOMODIGITAL SUBCUTANEOUS FLAP FOR COVER OF DORSAL FINGER DEFECTS

The authors propose a volar subcutaneous pedicled flap to cover skin d efects over the dorsum of the same finger. This flap includes all the subcutaneous (adipofascial) tissues from the reticular dermis to the s ynovial sheath of the flexor tendons. After elevation of the dermo-epi dermal flap, the subcutaneous tissues are raised as a flap predicted l aterally on one of the collateral arteries which constitutes the axis of rotation and transposition. After release of the collateral neurova scular bundle from its connections with the skeleton, the skin and the synovial sheath, the flap can be transposed to the dorsum of the fing er and then covered with a split thickness skin graft. The advantages of this technique are: (1) No functional or cosmetic sequelae at the d onor site which is closed by the volar dermo-epidermal flap; (2) Homod igital flap. This is particularly helpful in cases of multidigit invol vement where cross-finger flaps cannot be performed; (3) Vascular reli ability; (4) Preservation of both collateral arteries.