Reverse vascular pedicle digital island flap.

In 7 cases involving 8 fingers, amputation of the distal phalanx of the finger with defects of the pulp were covered by island flaps with the digital vessels acting as reverse vascular pedicles. The survival of the island flap was successful in all cases. The vascularisation of the island flap is derived from the digital palmar arch which is the anastomosis between the radial and ulnar sides of the finger. This method uses a single operative field and covers the defect with volar skin having similar qualities. However, due to problems in sensory recovery, we limit the indications for this method to the middle, ring and little fingers of the non-dominant hand.