Analysis of thumb pulp reconstruction based on different local flaps: A systematic review.

The reconstruction of the thumb's pulp is challenging when considering that there is no consensus on which local flap will provide better prognosis and less financial impact. The aim of this study was to analyze the outcomes of the most used flaps for the trauma to the volar substance of the thumb, validating the main indications. This systematic review adhered to PRISMA guidelines and electronic searches were conducted in multiple databases (MEDLINE/PubMed, Virtual Health Library, Embase and Scopus) with studies published in the last ten years - until April 2022. The search resulted in the screening of 573 records, and twenty studies were included. Among the flaps analyzed and compared by outcomes and prognostic factors, there are First Dorsal Metacarpal Artery (FDMCA), modified (MFDMCA), Moberg flap, Heterodigital Neurovascular Island, Neurovascular Island Pedicle and Modified Littler. Through this literature review, we can analyze different flaps widely used in the daily life of hand surgeons. The flaps that were also positive in a global context, but with few criticisms, are the MFDMCA, Moberg Flap, Neurovascular Island pedicle flap and FDMCA. However, it is important for the surgeon to consider different prognostic factors when choosing the flap, since these aspects directly impact the return to daily activities after the procedure.

© 2024 Society for Indian Hand Surgery and Micro Surgeons. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.