Rhomboid design for tubed inguinal flap in fingertip reconstruction

Abstract

The authors present a rhomboid design for the tubed inguinal flap mainly nourished by the superficial circumflex iliac vessels and the superficial inferior epigastric vessels. The length and width of the flap are mathematically determined based on the perimeter and length of the fingertip soft-tissue defect, respectively. The rhomboid tubed inguinal flap was used in the treatment of 21 patients with a variety of fingertip injuries. The thumb was involved in 12 patients and other digits in 9 patients. A complication, flap necrosis, occurred in one obese female patient and osteomyelitis of an amputated phalangeal bone developed in another. In all other patients, the rhomboid tubed inguinal flap healed uneventfully and provided satisfying results with minimal donor site morbidity. As a secondary procedure in thumb injuries, four neurovascular island flaps and one wrap around flap from the great toe were done for improved sensation. The precisely tailored rhomboid flap, with a safe and abundant vascular pedicle, allows for effective reconstruction of the fingertip with easy primary closure and minimal morbidity of the donor site.