Application of skin tension evaluation in syndactyly release without skin graft

Objective To explore the indications of simple syndactyly release without skin graft by analyzing the tension of skin in each segment. Methods In 38 cases of syndactyly release without skin flap, the tension of the fused skin was assessed segmentally. The relationship between the skin tension and the postoperative complications was analyzed to deduct the indications of simple syndactyly release without skin graft. These indication criteria were then applied to 10 finger webs in congenital syndactyly to verify the feasibility of these indications. Results Retrospective analysis of 38 cases showed skin necrosis at the distal phalange in 2 cases that resulted in nail deformities, and sunken lateral nail fold in 1 case. The above 3 cases were proven to be unsuitable for syndactyly release without skin graft according to our skin tension criteria. The 10 prospective cases which were performed with or without skin grafting based on the skin tension criteria all had satisfactory function and appearance. Conclusion Preoperative evaluation of the tension of the fused skin segmentally could predict the indication of skin graft in syndactyly release and guide the surgical design. Key words: Hand deformities,congenital; Syndactyly; Skin tension assessment