LOCAL FLAPS AND SPLIT;

SENSORY DEFICIT IN TERM OF TWO POINT DISCRIMINATION (TPD) THICKNESS SKIN GRAFTS (STSG)

Abstract

Background: Two point discrimination (TPD).is the minimum distance between two stimulus points on the skin, which are
perceived as distinct points, Among the two types of TPD i.e., static and dynamic, static two-point discrimination (STPD) is commonly used to
determine digital nerve integrity. Local flaps usually do well in maintaining sensibility of the covered area in terms of two point discrimination in
contrast to s-plit thickness skin grafts (STSG). Objective: The objective of this study was to determine the frequency of sensory deficit in terms
of TPD in STSG and local flaps for soft tissue defects of fingers after three months. Study design: It was a Quasi experimental study. Settings:
Patients admitted in the indoor of Plastic surgery department, Services Hospital Lahore. Period: February 2009 to January 2010. Material and
Methods: Thirty five patients underwent local flap coverage and other thirty five underwent split thickness skin grafting for soft tissue defects of
fingers depending upon nature of defect. Patients were followed up at 2, 4, 8 and 12 weeks. Results: The sensory deficit observed at the end of
12th week post operatively was in 8.6% of the patients with local flap coverage (3 patients) and 45.7% of those with STSG (16 patients).
Patients with no sensory deficit were 91.4% (32 patients) in the local flap coverage and 54.3% (19 patients) in the STSG at 12th week of follow
up. The relative ratio of sensory deficit in local flaps and STSG was 5 (>2). Conclusions: The results of this study show that Local flaps are
better options in terms of TPD preservation as opposed to STSG for soft tissue defects of fingers.