Mehmet TAPAN, Ramazan Erkin ÜNLÜ, Ali Rıza YILDIRIM, Burak YAŞAR, Murat İĞDE, Mehmet Onur ÖZTÜRK

Littler Flap: A reliable option in soft tissue defects of different fingers

Amaç: Travma, yanık ve kontraktür açılmasını takiben parmak yumuşak doku defektleri sıktır. Heterodijital nörovasküler ada flebi, bu amaçla kullanılan önemli fleplerden biridir. Genellikle birinci parmak pulpa defektlerinin tamirinde kullanılmasına rağmen diğer parmaklarda oluşan defektleri için de kullanışlı bir seçenektir. Bu çalışmada sadece 1.parmakta değil farklı parmak yumuşak doku defektlerinin rekonstrüksiyonunda littler flebi kullanımı ve sonuçları sunulmuştur. Yöntem: Bu tanımlayıcı çalışmada, Ağustos 2012- Haziran 2014 tarihleri arasında nörovasküler ada flebi ile parmak yumuşak doku defekti rekonstrüksiyonu uygulanan 13 hasta (9 erkek, 4 kadın) çalışmaya dahil edilmiştir. Doku defekti, 4 hastanın başparmağında, 4 hastanın işaret parmağında, 3 hastanın orta parmağında, 2 hastanın da yüzük parmağında yer almaktaydı. Donor ve yaralanan parmaklar, hareket açıklığı ve duyu açısından değerlendirildi. Bulgular: Bu çalışma grubunda, fleplerin tamamı yaşadı. Ortalama 12 ay takipte, donor ve rekonstrükte edilen parmakların hareket açıklığına göre sonuçları tüm hastalarda mükemmel yada iyi olarak gösterildi. Donor saha morbiditesi kabul edilebilirdi. Hastalar, nadiren ağrı ve soğuk intoleransından yakınmaktaydı. Sonuç: Parmak defektlerinin rekonstrüksiyonunda bu flebin tercih edilmesinin en önemli nedeni, flep yaşayabilirliği için sabit pedikülü olması, tek aşamalı prosedür olması, elin erken hareketi, iyi fonksiyonel ve kozmetik sonuç nedeniyle uygun bir seçenektir. Bizim düşüncemiz, littler flep, donor saha morbiditesi ve flep komplikasyonları açısından son derece kullanışlı ve uygun olmasından dolayı, farklı parmak defektlerinde kullanılmalıdır.

Littler Flep: Farklı parmakların yumuşak doku defektlerinde güvenilir bir seçenek

Objective: Finger soft tissue defects are common following trauma, burn, and contracture release. Heterodigital neurovascular island flap is one of the important flaps used for this purpose. However, it is generally used for the repair of pulp defects involving first finger, it is also useful for defects involving other fingers. In this study, we presented our clinical findings on the use of and outcomes associated with Littler flap in the reconstruction of soft tissue defects involving not only first finger, but also different fingers. Method: This descriptive study included 13 patients (9 males, 4 females) who were treated with a neurovascular island flap for different finger soft tissue defect between August 2012 and June 2014. Tissue defect was located the thumb in 4 patients, index finger in 4 patients, middle finger in 3 patients and ring finger in 2 patients. We evaluated sensibility and range of motion of the injured finger and donor finger. Results: In the study group, all flaps survived completely. At a mean follow-up of 12 months, the results of the donor and reconstructed fingers regarding range of motion showed that all patients achieved excellent or good results. The donor-site morbidity was accepted. The patients rarely complained of pain or the cold intolerance of the flap. Conclusions: The most important reason for the preference given to this flap in the reconstruction of finger defects is a reliable option due to constant pedicle for flap viability, single stage procedure, early mobilization of the hand, good functional and cosmetic result. Our opinion is that a littler flap should be used in different finger defects since it is highly useful and reliable in terms of flap complications and donor field morbidities.

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