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CC BY-NC-ND 4.0 · Indian J Plast Surg 2022; 55(03): 224-233
DOI: 10.1055/s-0042-1744453
CME

Management of Complex Upper Extremity Trauma with Associated Vascular Injury

Ravi K. Mahajan
1   Department of Plastic and Reconstructive Surgery, Amandeep Hospital, Amritsar, Punjab, India
,
Krishnan Srinivasan
1   Department of Plastic and Reconstructive Surgery, Amandeep Hospital, Amritsar, Punjab, India
,
Adish Jain
1   Department of Plastic and Reconstructive Surgery, Amandeep Hospital, Amritsar, Punjab, India
,
Abhishek Bhamre
1   Department of Plastic and Reconstructive Surgery, Amandeep Hospital, Amritsar, Punjab, India
,
Udit Narayan
1   Department of Plastic and Reconstructive Surgery, Amandeep Hospital, Amritsar, Punjab, India
,
Manish Sharma
1   Department of Plastic and Reconstructive Surgery, Amandeep Hospital, Amritsar, Punjab, India
› Author Affiliations Funding None.
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Abstract

Introduction Combined soft tissue and vascular injuries of the upper extremity pose several challenges at once to the plastic surgeon. Many decisions have to be taken urgently that will influence the salvage or amputation of the affected extremity. The aim of this article was to provide an evidence-based outline for the management of such injuries. Learning objectives of this article are as follows: (1) approach to a patient with upper extremity composite tissue and vascular injury presenting to the emergency, (2) decision-making as to when to salvage and when to go for amputation of the traumatized upper extremity, (3) role of imaging in emergency situation, (4) role of fasciotomy, (5) intraoperative sequencing of steps, and (6) options for vascular reconstruction and the flaps used for coverage. After reading this article, the reader should have a clear understanding of the management of vascular injury in a patient with composite defects of upper extremity.

Keywords

upper extremity trauma - vascular injury - flow-through flap - free flap - complex upper extremity trauma


Publication History

Article published online:
30 August 2022

© 2022. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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