Toe digital artery perforator flap for coverage of defects on the toe

摘要

There are two main options for treatment of defects on the toe: reconstruction and secondary intention healing. The limited length of advancement is the major drawback in reconstruction via a V-Y closure and volar advancement flaps. Reverse-flow homodigital artery flaps may be too invasive because they entail deep dissection into the neu-rovascular bundle, which could result in postoperative tenderness. Free flap reconstruction necessitates special microsurgical techniques, a longer operative time and close postoperative monitoring. With secondary intention healing, rapid granulation and epithelialisation can be expected in younger patients. However, the healing process is slower in elderly patients, whose dressing changes can be bothersome. Worse, an open wound, especially in the toes, can be painful. To address these disadvantages, we report application of a toe digital artery perforator (Toe DAP) flap, nourished by small perforators issuing from the digital artery of the toe, for coverage of defects on the toe.