Microsurgical reconstruction of soft-tissue defects in digits

Injuries that cause soft tissue defects could threaten the function and viability of the involved digit. Reconstruction of such defects can be challenging and requires careful consideration in restoring both the aesthetic and functional deficit. The purpose of this review is to describe appropriate reconstructive technique using various free tissue transfers. According to the location and the size of a defect, a proper reconstructive option is indicated. Owing to the specialized mechano-sensory property of its volar soft tissue, fingertip injury, when significant defects exist, are reconstructed using specialized free flaps with appropriate histological and functional similarities. Composite tissue including bone may be required in selected cases. Additional procedures, such as secondary skin graft or division of the flap, should be done after several weeks of the first operation. Refinements and improvements in free tissue transfer allow an expanse of reconstructive options for soft tissue defect in the digit.