Defects over Proximal half of dorsum of any finger can be best managed with respective dorsal metacarpal artery perforator based reverse flap from dorsum of hand.
Advantages are single stage, same tissue in thickness and colour as on finger, in most cases donor defect can be closed primarily , reliable flap with consistent anatomy.
This patient has composite defect over dorsum of proximal phalanx of rt middle finger with exposed tendon and bone. skin loss over 3rd web space, ring and little fingers.
Wounds were debrided and flap based on 3rd dorsal metacarpal artery perforator raised and rotated almost 180 degree to reconstruct defect over middle finger. skin graft harvested from rt forearm and applied over donor area of flap and other raw areas. JESS applied to keep fingers abducted.
Hand surgery#bisoniya hospital#dr hari singh bisoniya#perforator flap