Dorsal metacarpal artery perforator-based flaps for the reconstruction of postburn dorsal finger defects

Abstract

Background: Burn injuries involving the dorsum of the hand are very common. Most burn injuries heal with dressings or skin grafting. Deep burns can lead to soft tissue defects and require durable cover to protect the underlying extensor tendons and the bone. Dorsal metacarpal artery-based flaps are reliable locoregional flaps that provide good soft tissue cover. Materials and Methods: This study included nine patients with postburn dorsal finger defects who underwent debridement and coverage using dorsal metacarpal artery perforator (DMAP)-based flaps from January 2019 to January 2022. Parameters in terms of flap dimensions, reliability, complications, and donor-site morbidity were assessed. Results: The flap size ranged from 5 cm × 2.5 cm to 7 cm × 2.5 cm. Two flaps had marginal necrosis, and one had venous congestion, which settled over time and healed with dressings. All the flaps settled well with a satisfactory outcome. The patients were followed up for 6–24 months. Conclusion: DMAP-based flaps are reliable in providing good soft tissue cover for reconstructing postburn dorsal finger defects with acceptable donor-site morbidity.

Keywords

• dorsal finger defects
• dorsal metacarpal artery
• perforator flap
• postburn reconstruction