A comparative study of finger pulp reconstruction using arterialised venous sensate flap and insensate flap from forearm

Objective: The aim of this study was to investigate the feasibility of finger pulp reconstruction using arterialised venous flaps from forearm and compare the outcomes of arterialised venous sensate flap and insensate flap. Methods: Twenty-seven arterialised venous flaps were reviewed retrospectively in the reconstruction of finger pulp defects in 23 patients, including 15 sensate flaps (sensate group) and 12 insensate flaps (insensate group). Nine flaps in this series were harvested from the dorsal aspect of the forearm and the other 18 were harvested from the volar aspect. Standardised assessment of outcomes in terms of objective sensory recovery, pinch power of the reconstructed digits, cold intolerance and time of returning to work was completed. Results: All flaps survived completely. Twenty-six flaps were available for follow-up of more than 9 months (mean, 15.4 months). Almost all the flaps in the sensate group obtained normal sensation, while most cases of the insensate group only achieved protective sensation. Cold intolerance was present in most cases of the insensate group in comparison with the sensate group with only one case suffering from slight cold intolerance. There was no significant difference of pinch power between the two groups. All the patients were contented with the aesthetic outcomes of the surgery. Conclusion: The arterialised venous sensate flap from forearm is a practical alternative for finger pulp reconstruction with satisfactory functional and aesthetic outcomes. The forearm region can be an acceptable donor site for arterialised venous sensate flap in the reconstruction of larger finger pulp defect. (C) 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.