American Society of Hirudotherapy

Preliminary Study on Functional and Aesthetic Reconstruction by Using a Small Artery-only Free Medial Flap of the Second Toe for Fingertip Injuries

Prospective case series published in Clinics (2019)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Research reportClinical TrialsLi M et al. · Clinics (Sao Paulo, Brazil), 2019

Abstract

OBJECTIVES: This study was designed to introduce the feasibility of fingertip reconstruction by using a free medial flap of the second toe without vein anastomosis. METHODS: In total, 8 patients with fingertip injuries were treated successfully with this method. Patients who underwent reconstruction from September 2016 to October 2017 in our hospital with an artery-only free medial flap transfer of the second toe for fingertip injuries were included, and patients who underwent additional procedures that may impact the postoperative results and were followed up for less than 6 months were excluded. Clinical trial registration: ChiCTR19000021883. RESULTS: According to the Allen classification, five patients had Type 3 injuries, and three patients had Type 4 injuries. One arterial nerve and one digital nerve were repaired at the same time. No additional dissection was performed in either the donor or recipient site of the dorsal or volar vein. Postoperative venous congestion was monitored based on the color, temperature and the degree of tissue oxygen saturation. The flap size ranged from 1.20*1.0 cm2 to 1.80*1.0 cm2. The reconstruction time was 71.86 (SD 14.75) minutes. The two-point discrimination and the monofilament results were satisfying; cold intolerance did not appear in five patients, and the other three patients had cold intolerance with grades of 4, 12 and 26, which were considered satisfactory. Moreover, leech therapy, continuous bleeding and needle sutures were not utilized in any cases. CONCLUSIONS: Reconstruction with a small artery-only free medial flap transfer of the second toe led to satisfactory sensory and motor function in the selected patients with fingertip injuries.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal Article
Indexed MeSH termsAdultArteriesFemaleFinger InjuriesFingersFollow-Up StudiesFree Tissue FlapsHumansMalePlastic Surgery ProceduresToes

Summary

Eight patients with fingertip injuries reconstructed with an artery-only free medial flap of the second toe; postoperative venous congestion monitored clinically. Notably, neither leech therapy, continuous bleeding, nor needle sutures were required in any case.

Why This Matters for Hirudotherapy

This study evaluated eight patients with fingertip injuries reconstructed using a small artery-only free medial flap of the second toe without vein anastomosis, achieving satisfactory sensory and motor function outcomes. Notably, the abstract explicitly states that leech therapy, continuous bleeding, and needle sutures were not utilized in any cases, with postoperative venous congestion monitored by color, temperature, and tissue oxygen saturation. The article has only indirect relevance to hirudotherapy: it describes a surgical technique for which leech therapy was not required, though the abstract does not frame avoiding leeches as a primary objective. No leech outcomes are reported.

Citation

Preliminary Study on Functional and Aesthetic Reconstruction by Using a Small Artery-only Free Medial Flap of the Second Toe for Fingertip Injuries.

Li M et al. · Clinics (Sao Paulo, Brazil), 2019

Added to ASH library: May 26, 2026 · Site last updated: June 18, 2026

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