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A New Technique In Tamai Zone 1 Reconstruction: Reverse Dorsal Terminal Vein Flap (hat Flap)
Bilsev Ince M.D., Mehmet Emin Cem Yildirim M.D., Mehmet Dadaci M.D.
Necmettin Erbakan University, Meram Faculty of Medicine Hospital, Department of Plastic Reconstructi
2018-02-14
Presenter: Mehmet Emin Cem Yildirim
Affidavit:
The presenter of the study, who is Mehmet Emin Cem Yildirim M.D., has active and major role in the study.
Director Name: Nedim Savaci
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand
PURPOSE
In this study, we aimed to investigate the useability of the reverse dorsal terminal vein flap (Hat Flap) that we identified in the reconstruction of Tamai Zone 1 defects.
METHODS
Eighteen patients who were referred to the emergency department with Tamai Zone 1 defect in any fingers except first finger were included in the study.
Surgical Technique: The flaps were designed from the proximal end of the nail bed to the middle phalanx according to the defect size. After passing through the skin, the proximal parts of the dorsal vein and branches were knotted. The flap was harvested by preserving the paratenon and dorsal digital terminal vein. To increase the rotation, the limited superior skin of the pedicle was deepithelized. Then, the flap was rotated and the defect was closed.
RESULTS The distal phalanx was not shortened in any of the patients. Loss of epidermis in 5 patients and partial flap loss in 1 patient were observed, but total flap loss was not observed in any patient. In 1 patient with partial flap loss, it was observed that the portion of the flap above the distal phalanx was intact. None of the patients had complications that would require a second flap surgery. In all patients, it was observed that the distal phalanx was smoothly closed and the finger pulp thickness was acceptable.
CONCLUSIONS The reverse flow terminal dorsal vein based pedicle flaps can be used as an alternative surgical technique in the reconstruction of Tamai Zone 1 amputations.
