Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 31;55(3):282-286.
doi: 10.1055/s-0042-1756125. eCollection 2022 Jun.

Study of Yang's Onion Flap Technique for Release of Scarred Eponychium and Nail Fold Reconstruction in Burn Patients

Vaishali Srivastava  1 , Upendra Sharma  2 , Deepak Rathore  3
Affiliations

Study of Yang's Onion Flap Technique for Release of Scarred Eponychium and Nail Fold Reconstruction in Burn Patients

Vaishali Srivastava et al. Indian J Plast Surg. .

Abstract

Background Abnormalities of fingernail growth and appearance are among the most common deformities encountered after burn injury to the hand. Various techniques used for resurfacing defects include incision of the scarred eponychium and advancement of the distal segment, flap reconstruction-distally, and proximally based transposition/advancement flaps, composite graft techniques, microvascular transfer. In the present study, we used an onion flap to release scarred eponychium and nail fold reconstruction in a single stage without using soft tissue from another area. Materials and methods Forty-four burnt fingers were operated using Yang's onion flap technique. Patients were assessed for flap necrosis, hematoma and infection in the early postoperative period and for donor site scar, nail appearance, and symptomatic relief in a follow-up for at least 4 months. Results The flap was successfully performed on all fingers. Only two fingers had flap necrosis. There was no incidence of hematoma or infection. The donor site scar and nail plate appearance improved and was acceptable to most patients after surgery. There was also significant relief in daily activities in 19 out of 28 symptomatic patients. Conclusion Yang's flap to correct nail deformities in burn patients is feasible in Indian scenario. It is associated with a low complication rate and improved nail appearance. There is also significant symptomatic relief in performing daily activities after surgery.

Keywords: nail fold reconstruction; onion flap; post-burn nail deformity.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Onion flap dorsal view.
Fig. 2
Fig. 2
Onion flap lateral view.
Fig. 3
Fig. 3
( A ) Middle finger with nail plate deformity. ( B ) Operative photograph. ( C ) Well-settled flap with improved nail growth at 6 months' follow-up, dorsal view. ( D ) Lateral view.
Fig. 4
Fig. 4
( A ) Post-burn nail deformity middle and ring fingers. ( B ) Intraoperative photograph of onion flap for middle finger, dorsal view. ( C ) Lateral view. ( D ) Improved nail growth seen in the middle finger as compared with ring finger.
Fig. 5
Fig. 5
( A ) Onion flap at postoperative day 7. ( B ) Flap at 2 month's follow-up. ( C ) Well-settled Onion bulb at 6 month's follow-up.
See this image and copyright information in PMC

References

    1. Goutos I, Jennings C L, Pandya A. Reconstruction of the burnt perionychium: literature review and treatment algorithm. J Burn Care Res. 2011;32(04):451–457. - PubMed
    1. Yang J Y, Yang S Y, Chen W F. “Onion” flap: a novel technique for reconstruction of burn nail deformities. J Trauma Acute Care Surg. 2012;72(05):1424–1428. - PubMed
    1. Duncan J AL, Bond J S, Mason T. Visual analogue scale scoring and ranking: a suitable and sensitive method for assessing scar quality? Plast Reconstr Surg. 2006;118(04):909–918. - PubMed
    1. Barfod B. Reconstruction of the nail fold. Hand. 1972;4(01):85–87. - PubMed
    1. Alsbjörn B F, Basse P. Surgical relocation of retracted eponychion. Acta Chir Plast. 1991;33(02):110–113. - PubMed