Frequency of Sensory Deficit in Terms of Two Point Discrimination in Split Thickness Skin Grafts and Local Flaps for Soft Tissue Defects of Fingers

Abstract

Introduction: Finger injuries that involve soft tissues can be traumatic, burn, or infection, and necessitate successful reconstruction in order to alter performance and sensation. The gold standard of sensibility examination is two-point discrimination and is central to fine motor activities. The most common reconstructive methods include split-thickness skin grafts (STSGs) and local flaps, and their sensory results vary greatly. Objective: To investigate the incidence of sensory loss with regard to two-point discrimination of post-reconstruction skin gaps in the finger soft tissues with reconstruction using split-thickness skin grafts and local flaps. Material and Method: The study was a descriptive cross-sectional study carried out at Department of Plastic Surgery and Burns, Bolan Medical Complex Hospital Quetta, Pakistan from 18^th March, 2025 to 19^th June, 2025. Sixty patients aged 18 to 60 with finger soft tissue defects were recruited and split into STSG and local flap groups. Exclusion criteria included diabetes, peripheral neuropathy, and previous surgery on the same digit. Reconstruction was performed according to defect characteristics. Sensory evaluation using static two-point discrimination was done at 12 weeks postoperatively, with results categorized as normal (≤6 mm), fair (6–10 mm), or poor (>10 mm). Results: In the STSG group, only 20% achieved normal discrimination, while 46.7% showed poor outcomes. In contrast, 46.7% of local flap patients had normal sensation, with only 16.6% demonstrating poor recovery. Conclusion: Local flaps provide superior sensory recovery compared to STSGs. Although grafts remain useful for coverage, flaps are preferable when functional sensibility is critical.