Random pattern sub-clavicular flap in digital degloving injuries: an alternative in the reconstructive ladder
DOI:
https://doi.org/10.18203/2349-2902.isj20233683Keywords:
Digital degloving injuries, Reconstructive surgery, FlapAbstract
Degloving soft tissue detachment injuries occur when the skin and subcutaneous tissue detach from the underlying structures, affecting the skin coverage. The hand is usually the most frequent affected site. In digital lesions, the best results are obtained by revascularization; nevertheless, this procedure is challenging for the surgeon. Random pattern flaps represent an effective alternative for the treatment of these devastating lesions. We present two clinical cases with digital degloving injury from the proximal phalanx. Both cases required reconstructive surgery in 2 stages, using a successful random pattern sub-clavicular flap. This article aims to share the results of using this method as another reconstructive option with good results. After an average follow-up of 8 months in both cases, adequate skin coverage and functionality of the finger treated with the described flap was observed. Patient A presents a finger with proper healing and functionality. Patient B at 10 months, presents a thumb with adequate length for clamping and opposition. Sub-clavicular flap is an excellent reconstructive alternative for digital degloving injuries where revascularization is unattainable, providing good skin coverage and functionality and being a reproducible outpatient procedure.
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References
Mumtaz SN. Degloving Injury: Evaluation and Management. Pak Armed Forces Med J. 2022;72(5):1555-9.
Karthikeyan G. Degloving injuries of the hand. Indian J Plastic Surg. 2011;44(2):227.
Latifi R, El-Hennawy H, El-Menyar, Ruben P, Mohammad A, Rafael C et al. The therapeutic challenges of degloving soft-tissue injuries. J Emergencies Trauma Shock. 2014;7(3):228-32.
McGregor IA. Degloving Injuries. Hand. 1970;2(2):130-33.
Telich-Tarriba JE, Velazquez E, Theurel-Cuevas A, Kenji S-P, Javier EA-A, Yusef JM et al. Upper Extremity Patterns of Injury and Management at a Plastic and Reconstructive Surgery Referral Center in Mexico City. Ann Plast Surg. 2018;80(1):23-26.
Maruccia M, Marannino PC, Elia R, Ribatti D, Tamma R, Nacchiero E et al. Treatment of finger degloving injury with acellular dermal matrices: Functional and aesthetic results. J Plastic Reconstruct Aesthetic Surg. 2019;72(9):1509-17.
Song B. The pre-expanded subclavicular island flap: A new tool for facial reconstruction. J Plastic Reconstruct Aesthetic Surg. 2016;69(12):1653-61.
Rentería Jorge González. COLGAJO SUBCLAVICULAR In: Atlas de Cirugía de Mano. 2nd edition. Editorial Trillas. México, DF. Editorial Trillas. 2007;235-6.
