Background In this study, we characterize the morbidity at the donor-site of partial second
toe pulp free flaps in terms of wound management as well as long-term outcomes.
Methods A single-institutional retrospective review was performed for patients who had undergone
partial second toe pulp free flap transfer to the fingertip. Patient charts were reviewed
for infection, skin necrosis, wound dehiscence, and hematoma for the donor site. Additionally,
a questionnaire survey was given to patients who had a follow-up of longer than 1
year to characterize long-term postoperative pain and appearance.
Results The review identified a total of 246 cases. Early wound complications were significant
for wound dehiscence (n=8) and hematoma (n=5) for a wound complication rate of 5.3%.
The questionnaire was distributed to 109 patients, and 54 patients completed the survey.
Out of these 54 patients, 15 patients continued to have donor-site pain (28%) at a
mean follow-up period of 32.4 months. However, the pain intensity was relatively low
in the range between 2 to 5, on a 0–10 scale. None of these patients felt this donor-site
pain interfered significantly with daily activity, nor did any patient require pain
medications of any type. Donor-site appearance was satisfactory to most patients.
Conclusions The partial second toe pulp flap was associated with low rates of wound complications
and favorable long-term outcomes. Given the functional and aesthetic gain in the recipient
finger, donor-site morbidities appear acceptable in this patient population. This
study can be helpful in counseling patients regarding donor-site morbidity during
the informed consent process.
Keywords
Free tissue flaps - Transplant donor site - Morbidity
