Objective: To explore a new method of pedicle skin incision and a improved new suture strategy when reverse digital artery island flap pedicled with finger proper palmar digital artery is used to repair fingertip skin defects,so as to reduce flap necrosis caused by pedicle entrapment. Methods: From October 2017 to January 2019, 38 distal fingers tissue deficiency of 32 patients were repaired with reverse digital artery island flap pedicled with finger proper palmar digital artery of the concealed and proximal segment of the injured fingers.The swelling degree of the transferred flaps and the flexion and extension function of fingers were observed after operation.Results:All 38 fingers survived after the operation.Thirty-six patients (36 fingers) were followed up 3-12 months,two patients (2 fingers) were lost. Conclusion: The pedicle of the flap cut by the improved new method is looser after being sutured by the innovative method, which effectively avoids the problem of pedicle entrapment and allows the pedicle with a width of 1cm to be retained, thus it ensuring the smooth venous reflux of the transferred flap and the survival of the flap.