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Journal of the Korean Society for Surgery of the Hand 2007;16(2):63-67.
Published online November 30, 2007.
Free Toe Tissue Transfer using Infiltration Method of Local Anesthetic Agent
Dong Lin Seo, M.D., Seung Ha Park, M.D., Byung Ihl Lee, M.D.
Department of Plastic and Reconstructive Surgery, Anam Hospital, College of Medicine, Korea University, Seoul, Korea. guro@korea.ac.kr
국소 침윤마취법을 이용한 족지조직 유리 피판술
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Abstract
  This study was designed to introduce free toe tissue transfer using infiltration method of local anesthetic agent. Four toe pulp tissues were transferred to reconstruct finger tip defect in four patients who were not suitable for general anesthesia. Two flaps taken from the lateral side of the great toe was used for reconstruction of thumb defect and two flaps from the medial side of the second toe for resurfacing of the index and fifth finger. Flap sizes were various from 2.0×2.0 cm2 to 1.6×4.0 cm2. Anesthesia was induced by infiltration of 2% lidocaine hydrochloride (with 1:100,000 epinephrine) with dilution of normal saline in same volume unit, as like as in ordinary digital block. All vessels were anastomosed within 2 cm of distance from the proximal margin of the defect. Whole operative procedures were carried out by one team. All flaps were successfully taken without complication. The average operation time was 4 hours 10 minutes. The amount of anesthetic agent used in whole operative procedures was roughly 4 mL in the toe, 8 mL in the finger, and 12 mL totally. In conclusion, free toe tissue transfer using infiltration method of local anesthetic agent would be good strategy for finger tip reconstruction in the patient not suitable for general anesthesia.
Key Words: Free toe tissue transfer, Infiltration of local anesthetic agent.
 
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