Arch Plast Surg.  2016 Jan;43(1):66-70. 10.5999/aps.2016.43.1.66.

Donor-Site Morbidity after Partial Second Toe Pulp Free Flap for Fingertip Reconstruction

• Kim HS
• Lee DC
• Kim JS
• Roh SY
• Lee KJ
• Yang JW
• Ki SH
• Harijan A

• KMID: 2167797
• DOI: http://doi.org/10.5999/aps.2016.43.1.66

Abstract

BACKGROUND
In this study, we characterize the morbidity at the donor-site of partial second toe pulp free flaps in terms of wound management as well as long-term outcomes.
METHODS
A single-institutional retrospective review was performed for patients who had undergone partial second toe pulp free flap transfer to the fingertip. Patient charts were reviewed for infection, skin necrosis, wound dehiscence, and hematoma for the donor site. Additionally, a questionnaire survey was given to patients who had a follow-up of longer than 1 year to characterize long-term postoperative pain and appearance.
RESULTS
The review identified a total of 246 cases. Early wound complications were significant for wound dehiscence (n=8) and hematoma (n=5) for a wound complication rate of 5.3%. The questionnaire was distributed to 109 patients, and 54 patients completed the survey. Out of these 54 patients, 15 patients continued to have donor-site pain (28%) at a mean follow-up period of 32.4 months. However, the pain intensity was relatively low in the range between 2 to 5, on a 0-10 scale. None of these patients felt this donor-site pain interfered significantly with daily activity, nor did any patient require pain medications of any type. Donor-site appearance was satisfactory to most patients.
CONCLUSIONS
The partial second toe pulp flap was associated with low rates of wound complications and favorable long-term outcomes. Given the functional and aesthetic gain in the recipient finger, donor-site morbidities appear acceptable in this patient population. This study can be helpful in counseling patients regarding donor-site morbidity during the informed consent process.

Keyword

Free tissue flaps; Transplant donor site; Morbidity

MeSH Terms

Counseling
Fingers
Follow-Up Studies
Free Tissue Flaps*
Hematoma
Humans
Informed Consent
Necrosis
Pain, Postoperative
Retrospective Studies
Skin
Tissue Donors
Toes*
Transplant Donor Site
Wounds and Injuries