Reconstruction of the finger pulp with palmar digital artery perforator propeller flap using a digital artery perforator at the lateral base of the finger pulp.

Abstract

Purpose: 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.

Methods: 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.

Results: All flaps survived completely despite transient congestion with the type B flap within 3 days of surgery.

Conclusions: Since this perforator is always present, the DAP flap is useful and yields esthetically pleasing results.