Mini-Shaped Kiss Flap Design for Palmar and Digital Soft Tissue Resurfacing.

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BACKGROUND: Although palmar and digital soft tissue resurfacing with intrinsic flaps may provide functional and aesthetic reconstruction, the donor site may result in a tight closure or need for a skin graft once the flap is raised. In this series, the "mini-shaped kiss" flap was utilized to increase the resurfacing efficiency while preserving hand function.

METHODS: The mini-shaped kiss flaps based on common palmar digital arteries, princeps pollicis artery and ulnar palmar digital artery were developed for the resurfacing of distal or proximal finger areas. The tiny skin paddles were kissed together and transferred as pedicled in proposed dimensions and shape. The flap size, donor/recipient site, perforator source, whether free or pedicled, surgical outcome and donor site morbidity were evaluated.

RESULTS: 20 mini-shaped kiss flaps were harvested for the purpose of palmar and digital resurfacing. The flap sizes varied from 3×1.2cm to 5×2cm. All 19 patients aged 6 to 52 years (mean 35 years) achieved successful reconstruction without major complications after 6 to12 months follow-up.

CONCLUSIONS: The mini-shaped kiss flap technique exhibited favorable surgical outcomes with excellent color and texture match to the recipient sites. The reverse midpalm, thenar and hypothenar island flap can be raised at the cost of an unnoticeable linear scar with minimized functional compromise in the donor area.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.




Medicine and Health Sciences




Department of Surgery

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