HS10FLAP COVERAGE IN UPPER LIMB INJURIES

• Published in: ANZ journal of surgery Vol. 77; no. s1; p. A35
• Main Author: Teoh, L. C.
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01.05.2007; Blackwell Publishing Ltd
• Subjects: Hand surgery; Injuries; Skin; Surgical techniques
• ISSN: 1445-1433; 1445-2197
• DOI: 10.1111/j.1445-2197.2007.04120_10.x

The severely of skin loss and the options of resurfacing is determined by taking into account the following factors. 1) The size & location of the defect, 2) The depth of the defect and the quality of the tissue bed, 3) The extent of exposed vital structures, 4) The associated bone and other tissues injuries, 5) The availability of donor skin flap. The size of the defect is the most important factor in choosing a resurfacing option. The size can be categorized into small, medium and large. A small defect is one that is less than 5 cm2 in size, a medium defect is between 5 to 15 cm2, and a large defect is greater than 15 cm2. Local flaps are usually sufficient to cover small defects <5 cm2. These are advancement flaps or rotation and transposition flaps. Regional flaps are indicated to resurface these medium-sized defects 5 to 15 cm2. The donor is within the same region of the hand, from one of the digits or from dorsum and palmar surfaces of the hand. It is usually based on vascular or NV pedicles. Large defects >15 cm2 will need larger flaps for coverage. These large flaps are pedicled distant flaps and free flaps. In these severe injuries, there is usually associated bone and soft tissues injuries. These injuries can be reconstructed as a single stage combined reconstruction or multi-staged reconstructions. The resurfacing should always be given priority. [PUBLICATION ABSTRACT]