Starnoni M, Benanti E, Acciaro AL, De Santis G. Upper limb traumatic injuries: A concise overview of reconstructive options.
Ann Med Surg (Lond) 2021;
66:102418. [PMID:
34141410 PMCID:
PMC8188247 DOI:
10.1016/j.amsu.2021.102418]
[Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 05/17/2021] [Indexed: 12/02/2022] Open
Abstract
Different options for upper limb reconstruction are described in literature: advancement or rotation flaps, regional flaps and free flaps are the most common. Local and regional flaps can represent the reconstructive options for small defects while large wounds require the use of free flaps or distant pedicled flaps. In case of large wound, the use of free flaps rather than distant pedicle flaps is usually preferred. To choose the best reconstructive option, it is essential for the surgeon to have a general overview about the different methods.
In this review the Authors will refer to the most commonly used methods to cover soft tissues injuries affecting the dorsum and the palm of the hand and the forearm (excluding fingers). The aim is to show all flap reconstructive options so as to support the inexperienced surgeon during the management of traumatic injuries of the upper limb.
Reconstruction of traumatic injuries of the upper limbs can be challenging.
Small defects can be covered by local and regional flaps while large wounds need the use of free or distant pedicled flaps.
The literature shows different opinions whether to use pedicled flaps (regional or distant) or free flaps.
Dermal substitutes can be considered in patients who are not suitable for flaps reconstruction.
Patient related factors and surgical background can significantly interfere with the surgical reconstructive solution.
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