Burns. 2025 May 7;51(6):107532. doi: 10.1016/j.burns.2025.107532. Online ahead of print.
ABSTRACT
OBJECTIVE: To investigate the safety and effectiveness of contiguous dorsal gullwing flaps for a single-stage interdigital web spaces reconstruction in patients with multiple-digit postburn syndactyly.
METHODS: A respective analysis was performed for 16 patients with multiple-digit postburn syndactyly who underwent surgery in a single-stage separation in our hospital from January 2016 to May 2023. The contiguous dorsal gullwing flaps were designed for interdigital web space reconstruction, at the same time using a zigzag incision to address scar contracture. Remaining skin defects would be covered with full-thickness skin grafts from the groin or wrist. A comprehensive review was conducted on various data points, including patient demographics, the scar pliability score per the Vancouver Scar Scale on the dorsal hand, the survival rates of flaps and skin grafts, preoperative and postoperative photographs, hand function assessments, patient satisfaction, and modified Withey scores.
RESULTS: The study included 12 boys and 4 girls with an average age of 42.13 ± 23.68 months, encompassing 37 affected web spaces. Among these patients, 11 cases involved three-fingered postburn syndactyly, meanwhile 5 cases were four-fingered postburn syndactyly. The follow-up time ranged from 6 months to 2 years. All flaps and skin grafts successfully survived without complications or web creep development. In the patient satisfaction survey, there were 10 cases of "very satisfied" and 6 cases of "satisfied". Based on the modified Withey score rule, the median value of digital flexion-extension deformity in the postoperative period was 0.63 ± 0.25, which was significantly lower than that of 1.88 ± 0.50 in the preoperative period (P < 0.001). The median value of web creep decreased from 3.38 ± 0.50 in the preoperative period to 0 in the postoperative period (P < 0.001). Besides, the median value of total Withey scores in the postoperative period was as low as 1.06 ± 0.25, compared with 6.69 ± 0.95 in the preoperative period (P < 0.001). Hand appearance and joint mobility were significantly improved post-operation.
CONCLUSION: Contiguous dorsal gullwing flaps enable an effective single-stage separation of multiple digits postburn syndactyly cases in which sufficient pliable dorsal skin is available. This approach not only prevents web space contracture but also reduces the need for subsequent surgical interventions, achieving both satisfactory aesthetic outcomes and functional digital reconstruction without complications.
PMID:40472490 | DOI:10.1016/j.burns.2025.107532