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Semin Plast Surg 2015; 29(01): 048-054
DOI: 10.1055/s-0035-1544170
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Soft Tissue Coverage of the Mangled Upper Extremity

Zhi Yang Ng
1   Department of Orthopaedic Surgery, Alexandra Hospital, Singapore
,
Christopher J. Salgado
2   Division of Plastic Surgery, University of Miami Miller School of Medicine, Florida
,
Steven L. Moran
3   Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota
,
Harvey Chim
2   Division of Plastic Surgery, University of Miami Miller School of Medicine, Florida
› Author Affiliations
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Publication History

Publication Date:
04 February 2015 (online)

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Abstract

Mangled upper extremity injuries usually involve high-impact trauma with crushing and tearing of the limb and its associated soft tissue structures. Such trauma is particularly mutilating because of the nature of the injury and the involvement of structures vital for proper function. Although advancements in flap technique and improvements in bone fixation methods have enabled good functional and clinical outcomes in limb salvage reconstruction, this remains a challenging area. Attempts at limb preservation should be fully exhausted before consideration is given for amputation, which results in significantly decreased function. Here the authors focus on the various modalities of soft tissue coverage available including allogenic substitutes, the adjunctive use of negative pressure wound therapy, and the design and utilization of flaps to address various defect configurations for the goals of wound healing, aesthetics, and functional restoration in the mangled upper extremity.

Keywords

upper extremity - hand - injury - soft tissue flap