Pedicled Abdominal Flap Reconstruction for Extensive Palmar Digital Necrosis in Diabetic Hand Infection: A Case Report

Diabetic hand infections are associated with significant morbidity and frequently result in amputation due to impaired vascularity and delayed wound healing. We report the case of a 46-year-old man with type 2 diabetes mellitus who developed palmar digital necrosis following a motor vehicle accident complicated by infection. Initial management at another institution included primary wound closure; however, progressive soft tissue infection and flexor tenosynovitis led to extensive tissue loss. Upon admission to our center, surgical debridement and placement of an irrigation catheter were performed. Given the compromised local vascularity and the extent of the palmar defect, a pedicled abdominal flap was selected for definitive coverage. The flap was divided after four weeks, followed by structured rehabilitation. The patient achieved favorable functional recovery with preserved sensation, satisfactory range of motion, and stable soft tissue coverage without recurrent infection. This case illustrates that pedicled abdominal flaps may represent a reliable limb-preserving option in selected patients with severe diabetic hand infections and extensive palmar tissue loss.