28th World Seminar on Surgery & Anesthesia
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Accepted Abstracts

Combined Reconstructive Surgery after Complex Hand Injuries: Clinical Case and Review of Literature

Domas Kurlavicius*
Faculty of Medicine, Vilnius University, Lithuania.

Citation: Kurlavicius D (2022) Combined Reconstructive Surgery after Complex Hand Injuries: Clinical Case and Review of Literature. SciTech Central Surgery 2022.

Received: April 01, 2022         Accepted: April 04, 2022         Published: April 04, 2022

Abstract

Complete amputation of the soft tissues of the hand (Degloving amputation) is one of the most difficult injuries to the hand. Tendons, bones, joints and other important structures expose directly in this trauma.  In order to restore the lost hand functions, it is important not only to operate the patient as soon as possible and cover the defects, but also to achieve the best possible functional and aesthetic results. The methods of treatment of the mentioned injuries, their variations are still an actual topic in the scientific articles and discussions. Local or regional flaps are usually not enough to cover defects during degloving amputation. After assessing the complexity of the trauma, multi – stage surgical treatment is applied. Microsurgery has provided greater opportunities  to cover these complex hand defects. At the same time, there is an opportunity to restore the sensations of the injured segment, which is very important for the hand. The thinner flaps are preferred for the best possible functional and aesthetic results of the injured hand. Fasciocutaneous, skin and muscle, skin perforator, omentum flaps are used. In our case, we used the dorsalis pedis flap.  Is is classified as a fasciocutaneous flap. The advantages of the dorsalis pedis flap are that it is thin and  it can restore the sensations of the damaged area. One of the most frequently mentioned disadvantages is difficult healing of donor site, such as hyperpigmentation, necrosis of the edges of the scin and scarring. We present the clinical case of the woman who has suffered from this trauma. We display the course of the treatment, the late functional and aestethetic results. The treatment was successful because the hand sensation was partially restored and the patient use it  at home. However, the healing of the donor side of the flap  was difficult.