Digital Artery Perforator Flap for Fingers Reconstruction: A Meta-Analysis Study with Clinical Cases

Document Type : Original Article

Authors

1 Department of Plastic Surgery, Elsahel Teaching Hospital, General Organization for Teaching Hospitals and Institutes, Cairo, Egypt

2 Department of Plastic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background: Local perforator flaps represent a new era for resurfacing soft-tissue defects of the hand. They provide durable coverage using flaps harvested from the closed vicinity of the defect. Digital artery perforator flaps [DAPF] have been recently used for finger reconstruction.
Purpose: This meta-analysis study with clinical cases was conducted to reveal the surgical and cosmetic outcomes of DAPF for reconstructing soft-tissue defects of the digits.
Methods: A systematic literature review was executed up to 1 April 2022. All clinical studies that included patients with finger defects and receiving DAPF for resurfacing finger defects were included. The flap survival rate and the rate of DAPF-related complications were evaluated.
Results: The present study included eleven articles comprehending 403 patients with 440 reconstructed finger defects. The rate of flap survival was 93.1% [95CI% 89.7%, 95.5%, p<0.001] while the rate of flap congestion was 17.3% [95CI% 6.8%, 37.6%, p=0.004]. Furthermore, the rate of flap necrosis was 8.9% [95CI% 5.7%, 13.7%, P<0.001] and the rate of superficial epidermolysis was 4.7% [95CI% 0.2%, 10.8%, P<0.001].
Conclusion: The DAPF is a reliable procedure for reconstructing soft-tissue defects in the fingers. It provides stable coverage with satisfactory functional and surgical outcomes. It is a convenient addition to the armamentarium for covering soft-tissue defects of the digits.

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