Efficacy of two flap repair techniques for thumb pulp defects

Objective: To compare the efficacy of dorsal thumb neurocutaneous vascular flap and dorsal flap of the index finger in the treatment of thumb pulp defects. Methods: From January 2014 to December 2016, 60 patients with thumb pulp defects admitted to Taizhou Hospital of Zhejiang Province were enrolled in this study. All patients were randomly classified into the observation group and the control group, with 30 patients in each group. Patients in the observation group underwent dorsal thumb neurocutaneous vascular flap for repair of thumb pulp defects, while those in the control group received dorsal flap of the index finger. The operation time, intraoperative blood loss, the rate of postoperative complications, patients' satisfaction with hand appearance, two-point discrimination and flap functions were compared between the two groups. Results: The observation group had substantially shorter operative time and less intraoperative blood loss than the control group (both P<0.05). There was insignificant difference in the rate of overall complications between the two groups (6.7% vs. 23.3%, P=0.148). Two-point discrimination was significantly lower in the observation group than in the control group (6.5 +/- 0.6 mm vs 7.3 +/- 0.7 mm, P<0.001). No significant difference was noted in the excellent and good rate of postoperative flap functions between the two groups (66.7% vs 73.3%, P=0.573). Conclusion: For repair of thumb pulp defects, dorsal thumb neurocutaneous vascular flap is superior to dorsal flap of the index finger in shorter operative time, less postoperative blood loss, higher satisfaction with hand appearance, and better recovery of two-point discrimination of patients. It is a preferred technique for repair of thumb pulp defects.