Insellappenplastik der ersten dorsalen Mittelhandarterie nach Foucher

AbstractObjective Coverage of soft-tissue defects of the thumb, which cannot be covered primarily or with a skin graft, by a neurovascular pedicled island flapfrom the dorsumof the index finger. Indications Combined skin and soft-tissue defects of the back of the hand, the thumbweb space, and especially the thumb. Contraindications Damages to the first dorsal metacarpal arteryor the rete carpale dorsale.Previous injuries to the flapdonor area.Local infection. Surgical Technique Outlining of the skin flapdesign on the dorsumof the in-dex finger. S-shaped skin incision at first web space radially. Identification of the first dorsal metacarpal arteryand preparation of a fascioneurovascular pedicle for flapsupply, with involvement of the fascia of the dorsal interosseous muscle in the flappedicle. Intersection of the island flapfrom the index finger. Preparation and uplifting of the flap. Tunneling of the island flapunder a skin bridge into the covering defect on the thumb. Fixation and suturing of the flapin the defect. Coverage of the flapdefect on the dorsumof the index fingerwith a skin graft.