Wenzhou Medical University, China
Title: Digital pulp reconstruction with free neurovascular toe flaps: Our experience and literature review
Hede Yan MD, Ph.D. is an Associate Professor and Master Supervisor of the 2nd Affiliated Hospital of Wenzhou Medical University. He achieved MD from Zhejiang University in June, 2002 and Ph.D. from Shanghai Jiaotong University in June, 2014. He is editorial board member of Annals of Plastic Surgery, Plastic and Aesthetic Research and International Journal of Orthopaedics and has specialized in microsurgery and reconstructive surgery. He has published 36 registered PubMed publications, which includes The Journal of Bone & Joint Surgery, Plastic and Reconstructive Surgery, etc. His research interests are mainly in the fields of reconstructive and microsurgery, hand surgery and peripheral nerve related research.
Finger pulp defects are commonly encountered in clinical settings and their treatment remains a consistent challenge for plastic and hand surgeons. Reconstruction should restore, as much as possible, the contour of the pulp as well as discriminating sensibility. Following the prime reconstructive principle of replacing "like with like," the free neurovascular toe pulp flap seems to be the optimal choice for digital pulp reconstruction because of the natural similarity of the digital pulp both anatomically and physically. However, after about 30 years of experience with this procedure, it is still controversial because it is technically demanding, involves donor site morbidity, and its reliability is questionable. With other small free flaps available, the application of this flap has been challenged and reconsidered. We specifically focus on the reconstruction of soft tissue defects of digital pulp using the free neurovascular toe flap, aiming to investigate its advantages and drawbacks and obtain a comprehensive understanding of this procedure. Our experience and the latest reconstruction concerns and technical refinements are also discussed.