Acute Free Flaps in Upper Limb and Hand Trauma

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Author(s): Farhan Ahmed Eitezaz, Mamoon Rashid, Adeela Hussain Khan, Saad-Ur-Rehman, AqsaAkhtar

Pages: 14-24 |

Objective/Purpose: To present our experience of managing hand and upper limb trauma defects with acute free flaps. Study Design: Descriptive case series. Place and Duration of Study: The study was held at the department of Plastic and Reconstructive Surgery between Jan 2012 and Jan 2018. Material and Methods: A total of 30 patients were operated on for reconstruction of upper limb and hand trauma defects with acute free flaps. The major etiologies were traffic accidents, crush injuries and electric burns. All defects produced after trauma and burns ( electric burns) were included in this study. Patients with toe to hand transfers were excluded from this study. X-rays were used to determine underlying fractures of the hand and long bones of the upper extremity in cases of trauma. Results: 30 patients were included in this study. Age range was 12 to 65years. Mean follow up time was 6 months. Post-operatively 8 patients suffered complications. Two patients had a partial loss of skin graft in the flap area. Wound dehiscence was seen at the donor site in two patients and at the recipient site in two patient. Two patients had graft loss in the donor area. All managed conservatively with daily dressings No mortality or flap loss was recordedin our senes . Conclusion: Acute free flaps are safe and provide reliable and immediate coverage restoring optimal hand function. Aggressive post operative physiotherapy and rehabilitation is essential for restoration of function.