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ORIGINAL ARTICLE
Year : 2019  |  Volume : 32  |  Issue : 4  |  Page : 1256-1261

Evaluation of dorsal metacarpal artery perforator flaps in the reconstruction of hand soft-tissue defects


1 Department of Plastic Surgery, Kafr Al-Shaikh General Hospital, Kafr Al-Shaikh, Egypt
2 Department of General Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt
3 Department of Plastic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Correspondence Address:
Tamer H Al-Baz
Kafr Al-Shaikh
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_365_18

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Objective Evaluation of the dorsal metacarpal artery perforator (DMAP) flaps in the reconstruction of hand soft-tissue defects. Background The DMAP flap is a nonconventional solution for treating hand and finger defects. We present our experience in resurfacing a variety of soft-tissue defects of hand and fingers with this single-stage flap, reducing the need for other conventional flaps which may need more than one stage for reconstruction. Patients and methods This study was done on 20 patients (18–65 years) with soft-tissue defects of the hand and fingers, following trauma in 15 patients, postburn deformity reconstruction in four patients, and in one patient for post-tumor excision, presented at the Menoufia University Hospital and Kafr Al-Shaikh General Hospital over a 1-year period. Results The average flap size was 6 × 2.5 cm; raised from the dorsum of the hand as an island elliptical flap. Twelve flaps were used to resurface defects between metacarpophalangeal and proximal interphalangeal joints; three flaps were used to resurface defects between proximal and distal interphalangeal joints; one flap was used to resurface defect beyond the distal interphalangeal joint; and four flaps were used to resurface web space defects. The donor site closed primarily in all cases. Complications were distal necrosis in two flaps and congestion in two flaps. Wound dehiscence of the donor site occurred in two cases. Conclusion DMAP flap is a reliable alternative for treating defects on the hand and fingers. The flap offers the surgeon simple, single-stage, and fast procedure with minimal donor site morbidity and with preservation of functional and esthetic outcomes.


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