Results of syndactyly release using a modification of the Flatt technique

The results of 144 congenital syndactyly releases over a 12-year period by a single surgeon using a modified Flatt technique (dorsal hourglass flap, interdigitating zigzag flaps, and full-thickness skin grafts) are analyzed considering the association of skin grafts and web creep. The mean follow-up was 5 years. There were seven cases of graft failure, only one of which developed web creep. Web creep occurred in 4.2% of web releases. The results suggest that avoiding longitudinal straight-line scars across the web space may be an important factor in avoiding web creep when performing the modified Flatt technique described.

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Syndactyly correction: an aesthetic reconstruction

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193410362638 ◽

2010 ◽

Vol 35 (6) ◽

pp. 446-450 ◽

Cited By ~ 21

Author(s):

R. M. Jose ◽

N. Timoney ◽

R. Vidyadharan ◽

R. Lester

Keyword(s):

Surgical Procedures ◽

Retrospective Review ◽

Skin Grafts ◽

Full Thickness ◽

Full Thickness Skin ◽

Thickness Skin ◽

Web Space ◽

Palmar Skin ◽

The Web

Various flaps have been used with and without skin grafts to separate digits with syndactyly. Dorsal flap techniques with and without grafts result in dorsal and thus more visible scars. Some of the recent techniques which use no grafts are only applicable for some simple syndactylies. The technique described in this paper uses a combination of techniques which have been described previously. A shaped palmar flap is used to create the web space; narrow V-flaps and full-thickness skin grafts are used to resurface the lateral defects on the fingers and reciprocal pulp flaps are used to create aesthetically pleasing nail folds. This technique allows the full thickness grafts to be hidden on the radial and ulnar sides of the fingers and palm. It increases the span of the hand in conditions where there is shortage of palmar skin. A retrospective review has been undertaken of 102 patients in whom 221 webs were reconstructed through 176 surgical procedures. There were 54 cases of simple syndactylies (53%) and the rest were complex. Complications were encountered in 11 operations (6%) and web creep was noted in 12 web spaces (5%). Re-operation for web creep has been carried out in seven web spaces (3%).

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The Use of Split Thickness Skin Grafts in the Correction of Apert’s Syndactyly

Journal of Hand Surgery (European Volume) ◽

10.1054/jhsb.2000.0507 ◽

2001 ◽

Vol 26 (1) ◽

pp. 8-10 ◽

Cited By ~ 6

Author(s):

M. M. AL-QATTAN

Keyword(s):

Skin Graft ◽

Joint Contracture ◽

Skin Grafts ◽

Thickness Skin ◽

Constant Feature ◽

Apert's Syndrome ◽

Web Space ◽

Skin Graft Contraction ◽

The Web

Stiffness of the interphalangeal joints of the fingers is a constant feature of Apert’s syndrome. Because of this stiffness, the author has used split-thickness skin grafts when correcting Apert’s syndactyly, thinking that contraction of such grafts post-operatively would not cause any joint contracture or finger deviation. This paper reports the results of eight patients whose average age at first surgery was 6 months. Separation of all digits was accomplished before the age of 2 years. A dorsal rectangular flap and interposing triangular digital flaps were utilised to create the web space and partially cover the skin defects in the fingers. The remaining digital defects were covered with thin split-thickness skin grafts which took fully in all cases. At final follow-up (1–6 years), the areas covered by skin grafts have reduced in size significantly because of skin graft contraction. However, this did not result joint contracture or digital deviation.

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Delayed Reconstruction with Full-Thickness Skin Grafts Following Defect Size Reduction in Head and Neck Nonmelanoma Skin Cancer

Facial Plastic Surgery ◽

10.1055/s-0040-1715619 ◽

2020 ◽

Author(s):

Baha Sezgin ◽

Isa Kaya ◽

Goksel Turhal ◽

Fazil Apaydin

Keyword(s):

Head And Neck ◽

Defect Size ◽

Size Reduction ◽

Skin Grafts ◽

Full Thickness ◽

Full Thickness Skin ◽

Thickness Skin ◽

Defect Area ◽

The Mean ◽

Delayed Reconstruction

AbstractDifferent treatment modalities have been applied for nonmelanoma skin cancers (NMSCs) of the head and neck area. One of the most important points after surgical treatment is the selection of appropriate reconstruction methods. The aim of this study is to investigate the efficacy and feasibility of the use of both defect size reduction with sutures and secondary healing with delayed reconstruction with full-thickness skin grafts in NMSC patients. In total, 18 (42.8%) male and 24 (57.2%) female patients with NMSC were operated. Defect size was measured both after excision and just before repair, and the approximate defect area was calculated with ImageJ software. Reconstruction was performed after 14 days in all patients in the second session, using free skin grafts. There were 18 (42.8%) male and 24 (57.2%) female patients. The mean age was 70.5 (45–82) years. The mean follow-up period was 40.3 (16–68) months. The mean defect area measured after excision was 8.44 ± 1.91 cm2. After 14 days of delay, the mean defect area was 5.51 ± 1.28 cm2 (34.8% reduction) (p < 0.05). Defect-reduction methods applied during the first session, together with proper interval prior to placement of graft, have been shown to be beneficial and acceptable methods, providing an advantage in reconstruction with free skin graft.

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