Delayed Infection After Thumb Reconstruction Using a Wrap-Around Flap: A Report of Two Cases

Abstract

　Background: The wrap-around flap is an established surgical technique that provides functional and aesthetic reconstruction for thumb defects. Although postoperative infection is uncommon, it can severely compromise surgical outcomes. This report presents two cases of delayed infection following thumb reconstruction using a wrap-around flap.
　Case presentation: Case 1 involved a 45-year-old man who developed an infection 6 years after thumb reconstruction. Case 2 involved a 29-year-old man who presented with purulent discharge 9 months after thumb reconstruction. Both patients sought medical attention 1 week after symptom onset. Radiographs confirmed osteolysis around retained Kirschner wires (K-wires) , suggesting that their prolonged retention contributed to the delayed infection. The infections were successfully managed by removing the fixation wires, performing repeated debridement, and placing antibiotic-impregnated cement.
　Conclusions: Prolonged retention of K-wires may contribute to delayed infection after wrap-around flap reconstruction. Careful determination of the duration of internal fixation and patient education regarding early consultation are essential to prevent and manage such complications.