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Garza de la Llave et al. Syndactyly release with a vascular random pattern flap

Figure 3: Surgical incision according to the desired web space depth Figure 4: Interdigital space dissection

Figure 5: 3:1 (length:base) relationship to ensure vascularity Figure 6: Flap rotation

Postoperative care
Post-operative analgesia and prophylactic antibiotics
are recommended. Patients are discharged from
hospital the next day. Moisture at the surgical site
can modify the results of the procedure and may
cause wound dehiscence or infection and must be
carefully managed. Suture removal is unnecessary as
absorbable sutures are used. Scar moisturization can
commence at the 2-week point. Patients are reviewed
at the hand surgery clinic weekly during the first month,
monthly for the next 2 months and every 2 months
subsequently until final clinic discharge.
Figure 7: Flap fixation and donor site primary closure
Outcome
achieve full coverage of the newly created webspace. We present 7 cases with incomplete simple syndactyly
Then the flap can be tailored away to remove redundant of the 2nd, 3rd or 4th webspace of multiple etiologies,
skin [Figure 6]. presenting to the hand surgery service of the
corresponding author and operating between February
Flap fixation and closure 2015 and May 2016. Cases include both unilateral and
Single sutures of 5-0 Vicryl are placed to secure the bilateral presentations of syndactyly [Table 1].
flap in the desired position. The donor site is closed
primarily with simple interrupted 5-0 absorbable A proximally-based vascular random pattern flap was
sutures [Figure 7]. Care must be taken to avoid any used to provide skin coverage to the webspace in all
kind of tension on the donor finger that may modify cases.
the shape of the finger, cause deformity, limit finger
movement or cause ischemia. The hand is splinted in The demographics comprised 4 males and 3 females
a neutral position for the first post-operative week. of an average age of 10.14 years (range 1-18 years).

72 Plastic and Aesthetic Research ¦ Volume 4 ¦ April 27, 2017