Nvi Neurovascular island flap single stage for Thumb Defect

Neurovascular Island Flap - Littler Flap

Indication

Mainly used to cover thumb pulp defects with sensation to flap

This patient with avulsion injury where pulp was not re-implantable

Planning

Lint pattern was taken for the defect.

Flap marked on the ulnar side middle finger.

Not to cross Mpx level

Dissection

Palmar incision are made first.

Then flap tip is dissected and raised.

Tunnelling

Subcutaneous Tunnel is made to inset the flap on the defect .

Inset

After perfusing the flap adequately.

Inset is given . Ssg harvested from arm.

Graft / Dressing

Tie over dressing is done .

First look is done at 2days,5th day graft first look10th day suture removal.

Follow up

Splinting of Middle finger is done. 

Mobilization of all fingers done.

Sensory re-education is done.