V-Y ADVANCEMENT FLAP IN SOFT TISSUE DEFECT COVERAGE - LITERATURE REVIEW AND A CASE REPORT OF FINGERTIP DEFECT RECONSTRUCTION OF THE LEFT RING FINGER FOLLOWING OCCUPATIONAL INJURY IN SOUTH SUDAN
DOI:
https://doi.org/10.59354/ydth175.2026.505Keywords:
V-Y advancement flap, Fingertip defect, Soft tissue coverageAbstract
Fingertip amputation is one of the most common injuries of the upper extremity. The goal of treatment is to maximize the preservation of length, sensation, and function of the fingertip, facilitating a rapid return to work. The V-Y advancement flap is a primary option for covering fingertip amputation defects. This technique is widely adopted due to its simplicity, not requiring the dissection of major neurovascular bundles, and the absence of complex equipment.
We report a clinical case of a 40-year-old Ghanaian male chef who sustained a soft tissue defect of the left ring finger pulp due to an occupational accident. The defect was covered using a V-Y advancement flap. Four weeks post-treatment, the patient achieved successful primary wound healing, and sensation was almost completely restored with a two-point discrimination of 5 - 6 mm. The patient maintained a normal range of motion (ROM) in the finger joint and returned to work after four weeks.
Literature suggests that flap surface tension is a main concern that may lead to flap necrosis or a “hook-nail” deformity. Modified techniques, such as allowing the donor site to heal by secondary intention, are used to increase safety and reduce tension upon skin closure. Furthermore, in addition to digital reconstruction, the V-Y flap has proven to be a versatile technique, applicable in the reconstruction of complex defects in other areas such as the tongue, the temporal region after Mohs surgery, and the perianal region (V-Y musculocutaneous flap).
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