The reverse digital artery flap (RDAF) is useful for skin coverage of the finger, but postoperative flap congestion is a serious problem.
The degree of flap congestion varies with the type of injury and may affect the treatment for congestion.
We examined the treatment outcomes of 24 fingertips by separating them by the type of injury based on the presence of a narrow skin bridge. There were 13 cases in the crush group and 11 cases in the avulsion group. Congestion was confirmed in half of the crushed skin bridge ( - ) group. In the crushed skin bridge ( + ) group, congestion was not observed. In the avulsion skin bridge ( - ) group, congestion was observed in all cases. In the avulsion skin bridge ( + ) group, low grade congestion was observed. A RDAF will adequately survive without the skin bridge in crush injuries, but congestion can be avoided by attaching the skin bridge. In the case of avulsion injury, the flap can survive, but congestion cannot be avoided only with a skin bridge, and it is likely that a wider skin bridge or subcutaneous venous network will be needed.
