THE OUTCOMES OF THE FOREARM FLAP APPLICATIONS IN THE UPPER LIMB SEVERE INJURIES RECONSTRUCTION
Objective: Improving the outcomes of surgical treatment of upper limb (UL) injuries by using regional soft tissue flaps. Methods: The analysis of surgical interventions outcomes of integumentary tissue defects and forearm and hand structures of traumatic genesis was conducted in 37 patients. Trau...
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| Format: | Article |
| Language: | English |
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Avicenna Tajik State Medical University
2021-09-01
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| Series: | Паёми Сино |
| Subjects: | |
| Online Access: | https://doi.org/10.25005/2074-0581-2021-23-3-450-461 |
| _version_ | 1797801138310873088 |
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| author | G.D. KARIM-ZADE M.KH. MALIKOV B.A. ODINAEV M.A. KHASANOV N.M. MIRZOEV N.A. MAKHMADKULOVA |
| author_facet | G.D. KARIM-ZADE M.KH. MALIKOV B.A. ODINAEV M.A. KHASANOV N.M. MIRZOEV N.A. MAKHMADKULOVA |
| author_sort | G.D. KARIM-ZADE |
| collection | DOAJ |
| description | Objective: Improving the outcomes of surgical treatment of upper limb (UL) injuries by using regional soft tissue flaps.
Methods: The analysis of surgical interventions outcomes of integumentary tissue defects and forearm and hand structures of traumatic genesis was conducted in 37 patients. Traumatic injuries to the forearm and hand structures with soft tissue defects occurred in 11 patients, and 26 trauma patients were hospitalized. The patients had superficial soft tissue defects (STDs) involving various areas, accompanied by damage to the underlying neurovascular bundles (NVBs), tendons and bones.
Results: Depending on the nature of trauma and the injured tissues’ state, the reconstruction sequence’s principle was followed. In 32 (86.5%) cases, the restoration of functional skin integument and reconstruction of injured anatomical structures of the limb were performed in a single stage. Twostage reconstruction was carried out in 5 (13.5%) patients, with initial STDs repair followed by reconstruction of the NVBs and tendons. Selection criteria for a sequence of surgical repair included the nature of the injury and the severity of the patient’s condition in emergencies. The following grafts were used: RFFF: radial forearm free flap (n=3); RRF: the reverse radial forearm flap (n=25); the ulnar reverse forearm flap (n=6), PIA: posterior interosseous artery flap (n=3). In the immediate postoperative period, compromised blood circulation in the transplanted flaps were observed in 2 (5.4%) cases. Timely diagnosis and treatment resulted in a positive outcome. Long-term functional and aesthetic outcomes of the reconstruction were considered acceptable in all patients.
Conclusion: A proper surgical procedure selection for UL structures injuries and their consequences influences long term postoperative aesthetic and functional outcomes. Choice of single or multiple stages of reconstruction largely depends on the location of the defect, the state of the tissues in the recipient area and the nature of the injury to the underlying anatomical structures of the limb. |
| first_indexed | 2024-03-13T04:45:52Z |
| format | Article |
| id | doaj.art-e11da29ce0af4111b3b7a3d046623056 |
| institution | Directory Open Access Journal |
| issn | 2074-0581 2959-6327 |
| language | English |
| last_indexed | 2024-03-13T04:45:52Z |
| publishDate | 2021-09-01 |
| publisher | Avicenna Tajik State Medical University |
| record_format | Article |
| series | Паёми Сино |
| spelling | doaj.art-e11da29ce0af4111b3b7a3d0466230562023-06-18T19:56:43ZengAvicenna Tajik State Medical UniversityПаёми Сино2074-05812959-63272021-09-0123345046110.25005/2074-0581-2021-23-3-450-461THE OUTCOMES OF THE FOREARM FLAP APPLICATIONS IN THE UPPER LIMB SEVERE INJURIES RECONSTRUCTIONG.D. KARIM-ZADE0M.KH. MALIKOV1B.A. ODINAEV2M.A. KHASANOV3N.M. MIRZOEV4N.A. MAKHMADKULOVA5Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University, Dushanbe, Republic of TajikistanDepartment of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University, Dushanbe, Republic of TajikistanDepartment of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University, Dushanbe, Republic of TajikistanDepartment of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University, Dushanbe, Republic of TajikistanDepartment of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University, Dushanbe, Republic of TajikistanDepartment of Operative Surgery and Topographic Anatomy, Avicenna Tajik State Medical University, Dushanbe, Republic of TajikistanObjective: Improving the outcomes of surgical treatment of upper limb (UL) injuries by using regional soft tissue flaps. Methods: The analysis of surgical interventions outcomes of integumentary tissue defects and forearm and hand structures of traumatic genesis was conducted in 37 patients. Traumatic injuries to the forearm and hand structures with soft tissue defects occurred in 11 patients, and 26 trauma patients were hospitalized. The patients had superficial soft tissue defects (STDs) involving various areas, accompanied by damage to the underlying neurovascular bundles (NVBs), tendons and bones. Results: Depending on the nature of trauma and the injured tissues’ state, the reconstruction sequence’s principle was followed. In 32 (86.5%) cases, the restoration of functional skin integument and reconstruction of injured anatomical structures of the limb were performed in a single stage. Twostage reconstruction was carried out in 5 (13.5%) patients, with initial STDs repair followed by reconstruction of the NVBs and tendons. Selection criteria for a sequence of surgical repair included the nature of the injury and the severity of the patient’s condition in emergencies. The following grafts were used: RFFF: radial forearm free flap (n=3); RRF: the reverse radial forearm flap (n=25); the ulnar reverse forearm flap (n=6), PIA: posterior interosseous artery flap (n=3). In the immediate postoperative period, compromised blood circulation in the transplanted flaps were observed in 2 (5.4%) cases. Timely diagnosis and treatment resulted in a positive outcome. Long-term functional and aesthetic outcomes of the reconstruction were considered acceptable in all patients. Conclusion: A proper surgical procedure selection for UL structures injuries and their consequences influences long term postoperative aesthetic and functional outcomes. Choice of single or multiple stages of reconstruction largely depends on the location of the defect, the state of the tissues in the recipient area and the nature of the injury to the underlying anatomical structures of the limb.https://doi.org/10.25005/2074-0581-2021-23-3-450-461upper limbinjuries and their consequencessoft-tissue defectflaps. |
| spellingShingle | G.D. KARIM-ZADE M.KH. MALIKOV B.A. ODINAEV M.A. KHASANOV N.M. MIRZOEV N.A. MAKHMADKULOVA THE OUTCOMES OF THE FOREARM FLAP APPLICATIONS IN THE UPPER LIMB SEVERE INJURIES RECONSTRUCTION Паёми Сино upper limb injuries and their consequences soft-tissue defect flaps. |
| title | THE OUTCOMES OF THE FOREARM FLAP APPLICATIONS IN THE UPPER LIMB SEVERE INJURIES RECONSTRUCTION |
| title_full | THE OUTCOMES OF THE FOREARM FLAP APPLICATIONS IN THE UPPER LIMB SEVERE INJURIES RECONSTRUCTION |
| title_fullStr | THE OUTCOMES OF THE FOREARM FLAP APPLICATIONS IN THE UPPER LIMB SEVERE INJURIES RECONSTRUCTION |
| title_full_unstemmed | THE OUTCOMES OF THE FOREARM FLAP APPLICATIONS IN THE UPPER LIMB SEVERE INJURIES RECONSTRUCTION |
| title_short | THE OUTCOMES OF THE FOREARM FLAP APPLICATIONS IN THE UPPER LIMB SEVERE INJURIES RECONSTRUCTION |
| title_sort | outcomes of the forearm flap applications in the upper limb severe injuries reconstruction |
| topic | upper limb injuries and their consequences soft-tissue defect flaps. |
| url | https://doi.org/10.25005/2074-0581-2021-23-3-450-461 |
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