Transverse V-Y advancement composite tissue flap for repairing defects after longitudinal melanonychia excision—a retrospective cohort study

Longitudinal melanonychia (LM) is a common nail disorder that sometimes requires surgical excision to rule out malignancy. However, longitudinal complete removal of LM, as one type of method for some special patient, can leave a significant defect in the nail bed. We introduced and assessed the appl...

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Main Authors: Jianhua Zhang, Zhenjun Xie, Wei Su
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Surgery
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Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2025.1575700/full
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author Jianhua Zhang
Zhenjun Xie
Wei Su
author_facet Jianhua Zhang
Zhenjun Xie
Wei Su
author_sort Jianhua Zhang
collection DOAJ
description Longitudinal melanonychia (LM) is a common nail disorder that sometimes requires surgical excision to rule out malignancy. However, longitudinal complete removal of LM, as one type of method for some special patient, can leave a significant defect in the nail bed. We introduced and assessed the application of transverse V-Y advancement composite tissue flap, a novel surgical procedure designed to address these defects. From September 2017 to January 2024, a total of 17 patients with LM underwent complete excision of the affected nail bed. The tissue defects ranged from 3 to 8 mm in width. The wounds were repaired using the transverse V-Y advancement composite tissue flap, which included the nail, nail fold, and adjacent finger pulp skin. All patients were followed up to assess flap survival, nail regrowth, and functional outcomes, and the mean follow-up time was 14 months, with a range of 6–23 months. All 17 flaps survived without complications. Nail regrowth was satisfactory in 15 cases, with only 2 cases showing a slight longitudinal ridge. Sensory recovery was well in all patients. Recurrence of LM was observed in 1 case (5.9%) during the follow-up period. The transverse V-Y advancement composite tissue flap is a reliable and effective alternative for repairing defects after LM complete excision identified as the indicating lesion, particularly for defects ranging from 3 to 8 mm in width. This technique significantly improves both functional and cosmetic outcomes, with high patient satisfaction.
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spelling doaj-art-328f526ba6184beb99f2e4d0f117b7212025-08-20T03:14:53ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-04-011210.3389/fsurg.2025.15757001575700Transverse V-Y advancement composite tissue flap for repairing defects after longitudinal melanonychia excision—a retrospective cohort studyJianhua Zhang0Zhenjun Xie1Wei Su2Department of Orthopaedics Trauma and Hand Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, ChinaDepartment of Hand and Foot Microsurgery, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, Henan, ChinaDepartment of Orthopaedics Trauma and Hand Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, ChinaLongitudinal melanonychia (LM) is a common nail disorder that sometimes requires surgical excision to rule out malignancy. However, longitudinal complete removal of LM, as one type of method for some special patient, can leave a significant defect in the nail bed. We introduced and assessed the application of transverse V-Y advancement composite tissue flap, a novel surgical procedure designed to address these defects. From September 2017 to January 2024, a total of 17 patients with LM underwent complete excision of the affected nail bed. The tissue defects ranged from 3 to 8 mm in width. The wounds were repaired using the transverse V-Y advancement composite tissue flap, which included the nail, nail fold, and adjacent finger pulp skin. All patients were followed up to assess flap survival, nail regrowth, and functional outcomes, and the mean follow-up time was 14 months, with a range of 6–23 months. All 17 flaps survived without complications. Nail regrowth was satisfactory in 15 cases, with only 2 cases showing a slight longitudinal ridge. Sensory recovery was well in all patients. Recurrence of LM was observed in 1 case (5.9%) during the follow-up period. The transverse V-Y advancement composite tissue flap is a reliable and effective alternative for repairing defects after LM complete excision identified as the indicating lesion, particularly for defects ranging from 3 to 8 mm in width. This technique significantly improves both functional and cosmetic outcomes, with high patient satisfaction.https://www.frontiersin.org/articles/10.3389/fsurg.2025.1575700/fulllongitudinal melanonychianail surgeryV-Y flaprepairing defectsretrospective cohort study
spellingShingle Jianhua Zhang
Zhenjun Xie
Wei Su
Transverse V-Y advancement composite tissue flap for repairing defects after longitudinal melanonychia excision—a retrospective cohort study
Frontiers in Surgery
longitudinal melanonychia
nail surgery
V-Y flap
repairing defects
retrospective cohort study
title Transverse V-Y advancement composite tissue flap for repairing defects after longitudinal melanonychia excision—a retrospective cohort study
title_full Transverse V-Y advancement composite tissue flap for repairing defects after longitudinal melanonychia excision—a retrospective cohort study
title_fullStr Transverse V-Y advancement composite tissue flap for repairing defects after longitudinal melanonychia excision—a retrospective cohort study
title_full_unstemmed Transverse V-Y advancement composite tissue flap for repairing defects after longitudinal melanonychia excision—a retrospective cohort study
title_short Transverse V-Y advancement composite tissue flap for repairing defects after longitudinal melanonychia excision—a retrospective cohort study
title_sort transverse v y advancement composite tissue flap for repairing defects after longitudinal melanonychia excision a retrospective cohort study
topic longitudinal melanonychia
nail surgery
V-Y flap
repairing defects
retrospective cohort study
url https://www.frontiersin.org/articles/10.3389/fsurg.2025.1575700/full
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AT zhenjunxie transversevyadvancementcompositetissueflapforrepairingdefectsafterlongitudinalmelanonychiaexcisionaretrospectivecohortstudy
AT weisu transversevyadvancementcompositetissueflapforrepairingdefectsafterlongitudinalmelanonychiaexcisionaretrospectivecohortstudy