In the reconstruction of fingertip and finger pulp defects, the step V-Y advancement flap is used because of its similarity and stability with the skin, acquisition of perception, and relatively inconspicuous scarring. A flap with high degrees of freedom can be made by crossing the distal interphalangeal crease in a step design. The suture line becomes a zigzag, and this wavy line effect can prevent scar contracture. In the design of the flap, the fundamental principles are making the skin incision orthogonal to the interphalangeal crease, making the angle of the steps sharp within 90°, and becoming familiar with the V-Y advancement methods and W-plasty technique.

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