Neurovascular skin island transfers were performed with the prime
objective of protecting vulnerable anesthetic areas on the hands of
patients with leprosy. After an average follow-up of eight years on sixteen
patients, all had long-lasting protective benefits without further loss of
tissue consequent to injury. At follow-up, two-point discrimination was
less than ten millimeters in only one patient, more than twenty millimeters
in ten, and indeterminate in five. Sensory misreference persisted in
fourteen patients. Axon sprouting was evident in six but only over short
distances (four to eight millimeters beyond the island). Compared with the
intact side of the donor finger, nine of the sixteen transfers had lost
some sensitivity but sensation was rated normal in one, nearly normal in
six, and protective only in nine. The loss of sensation in the donor finger
was less than expected and was not a problem. Scar contracture occurred in
two donor and five recipient fingers, but this could be attributed to
placement of the incision too far anteriorly, and hence was an unavoidable
complication. Restoration of protective sensation to the ulnar border of
the hand, whatever the cause of anesthesia, is considered extremely worth
while.