Modifiye Reverse Cross Finger Flap: Retikülodermo-Adipofasyal Flap

Objective: The reverse cross finger flap is a modified crossed finger flap with the advantages of the heterodigital island flap. Local flap reconstruction techniques have been used predominantly to repair small to medium-sized finger defects. This flap is considered suitable for all fingers except the thumb. The subdermal plexus provides the main blood supply of this flap. The aim of this study is to present the characteristics and results of patients treated in our clinic. Method: In our clinic, 11 patients with exposed bone, tendon, nerve or vessels on the dorsum of the finger; skin and soft tissue defects; and the need for reconstruction after tumoral mass excision were retrospectively investigated with the 'Modified Reverse Cross Finger Flap: Reticulodermo-Adipofascial Flap' technique. Results were evaluated. Results: The mean age of the patients was 57.2 years. 7 patients had a finger dorsal defect after trauma, 2 patients had a finger dorsal defect after tumoral mass excision, 1 patient had a finger dorsal defect after chronic wound excision, and 1 patient had a finger dorsal defect after burn scar revision. Modified Reticulodermo-Adipofascial Reverse Cross Finger Flap technique was applied to these defects. No flap loss was observed in any patient. No inclusion cyst was seen in the flap area. 2 patients had minimal, mild joint motion limitation at the distal interphalangeal joint. Wound site appearance and functional gain were acceptable and good. Conclusion: We prepared a stronger flap by incorporating only the reticular dermis into the adipofascial tissue. We also prevented the damage of the subdermal vascular plexus by couring the reticular dermis. In previous applications, the design of the reverse cross finger flap was planned as dermoadipofascial after the epidermis was de-epithelialized or as adipofascial after the epidermis and dermis were de-epithelialized. This flap design prevents the formation of cysts originating from hair, oil and sweat glands. In addition, this flap design prevents cyst formation and contributes to the blood supply of the flap.