• Dimitrios Dionyssiou, Anastasios Pagkalos, Athanasios Papas, Leonidas Pavlidis, Georgia Alexandra Spyropoulou, and Efterpi Demiri.
• Department of Plastic Surgery, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece. Electronic address: diodi@auth.gr.
• Injury. 2020 Dec 1; 51 Suppl 4: S48-S53.

BackgroundSoft tissue defects to the dorsum of fingers are quite demanding for the reconstructive surgeon especially in the cases that bone and extensor tendons are exposed. The purpose of our study was to describe a new adipofascial island flap by a single dorsal digital perforator (dorsal adipofascial digital artery perforator, DADAP).MaterialsMethods: In 8 patients (7 male, 1 female), 12 soft tissue defects to the dorsum of the fingers (3 index, 6 middle, 2 ring, 1 little finger), ranging from 1 × 2 cm to 2 × 4 cm, were reconstructed using the DADAP flap.ResultsThe flaps sizes ranged from 2.5 × 1.5 cm to 8 × 3 cm. The defects were covered in 9 cases by a propeller-rotation type flap and in 3 by a turn-over flap. In 4 cases a tendon graft was used to cover the tendon defect and in 3 cases an open joint was reconstructed. In all cases a splint thickness skin graft (SSG) covered the flaps. Mean follow-up was 18 months. One patient developed distal tip flap necrosis and was treated conservatively. Delayed wound healing with partial SSG failure due to haematoma was observed in 3 fingers, but the underlying flap was viable and complete healing was achieved by secondary intention.ConclusionsThe use of DADAP flap is a fast, safe and reliable solution to cover the defects of the dorsum of fingers and can be performed under local anaesthesia as a day surgery.Copyright © 2020. Published by Elsevier Ltd.

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