Objective:
Flap reconstruction of the fingers may have problems with function and contour. We aim to review the long-term outcomes of the one-stage secondary debulking procedure to restore the contour after groin flap reconstruction of finger.
Materials and Methods:
A retrospective review of finger reconstruction managed by a single senior plastic and reconstructive surgeon (TSL) at Kaohsiung Chang Gung Memorial Hospital with pedicle groin flaps was conducted. A total of 17 cases including one 2-year-old child were identified. Full thickness of the skin was harvested from the original flap, after which direct excision of the subcutaneous tissue and fat from the superficial fascia layer for dorsal side and deep fascia layer for volar side was performed under tourniquet control. Concomitant inter-digitalization of the banking digits in the flap was performed. The skin was then re-grafted onto the raw surface of the fascia after hemostasis was achieved and then fixed with bolster dressing. A finger splint was applied for immobilization until the dressing was removed 7 days after debulking.
Results:
The overall mean follow-up was 12 months. The mean interval time prior to debulking procedure after primary reconstruction was 3 months (range from 1-5 months). The reconstructed digits achieve comparable diameter and contour with regard of the contralateral side after debulking procedure. The two-point discrimination of the injured fingers of adults after 12 months of follow-up was 10.4 ± 1.6 mm (n = 16). The patients satisfied the procedures as very satisfying in 12 cases and good in 4 cases. Using a 5-point Likert scale, post-debulking fingers showed statistically significant improvement in terms of contour and texture compared to pre-debulking fingers.
Conclusion:
One-stage secondary debulking procedure resulted in excellent functional and aesthetic outcomes in finger after groin flap reconstruction.

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