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

Figure 8: Dorsal view. Preoperative and 4 months postoperative comparison of a 18-year-old patient with burn sequels in both hands. The
2nd and 3rd interdigital spaces were opened using the proposed technique. (A) Preoperative view; (B) 4 months postoperative view

Figure 9: Palmar view. Preoperative and 4 months postoperative comparison of a 18-year-old patient with burn sequels in both hands. The
2nd and 3rd interdigital spaces were opened using the proposed technique. (A) Preoperative view; (B) 4 months postoperative view

be included in the rotation flap forwebspace coverage resurface the first webspace, we do not consider this
[Figures 8 and 9]. flap a good option for these cases. The amount of soft
tissue that can be taken from the donor finger while
The possible disadvantages of this flap include allowing primary donor site closure is exceeded in
the risk of vascular insufficiency of the flap if an most of these cases.
insufficiently broad base (at least a 3:1 length-base
relationship) is not adhered to. There is also a risk of Possible complications of this flap include wound
vascular compromise if a wide donor area is taken dehiscence, infection, flap necrosis, flexion contracture
and primary closure is performed under tension. of the donor finger, and syndactyly relapse. In our
Flexion contracture of the proximal inter-phalangeal experience, this flap did not present any of the
joint of the donor finger can occur it the length of the aforementioned complications with the exception
flap surpasses the level of this joint and if sufficient of one case of surgical wound dehiscence that was
dissection is not performed adequately. Another resolved. No other complications were seen in our
disadvantage of the proposed flap is that both sides case series.
of a finger cannot be used simultaneously as flap
donors. This is due to the risk of vascular compromise Authors’ contributions
for the donor finger as well as the functional (flexion Manuscript’s preparation: H. Garza de la Llave
contraction) and aesthetic (deformity of the finger) Manuscript’s review: Y. Jiménez Murat
complications that may arise.
Concept design: H. Garza de la Llave
The proposed flap only improves soft tissue and as Literature search: A.Á. Corona Figueroa
such its use is limited to simple syndactyly cases. As Financial support and sponsorship
the flap cannot surpass the proximal interphalangeal
joint, its use is limited to cases of incomplete None.
syndactyly.
Conflicts of interest
Because of the large quantity of soft tissue needed to There are no conflicts of interest.

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