Soft Tissue Reconstruction of Complete Circumferential Defects of the Upper Extremity
Background Upper extremity soft tissue defects with complete circumferential involvement are not common. Coupled with the unique anatomy of the upper extremity, the underlying etiology of such circumferential soft tissue defects represent additional reconstructive challenges that require treatment...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2017-03-01
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| Series: | Archives of Plastic Surgery |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2017.44.2.117 |
| _version_ | 1828390459290943488 |
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| author | Zhi Yang Ng Shaun Shi Yan Tan Alexandre Gaston Lellouch Curtis Lisante Cetrulo Jr Harvey Wei Ming Chim |
| author_facet | Zhi Yang Ng Shaun Shi Yan Tan Alexandre Gaston Lellouch Curtis Lisante Cetrulo Jr Harvey Wei Ming Chim |
| author_sort | Zhi Yang Ng |
| collection | DOAJ |
| description | Background Upper extremity soft tissue defects with complete circumferential involvement are not common. Coupled with the unique anatomy of the upper extremity, the underlying etiology of such circumferential soft tissue defects represent additional reconstructive challenges that require treatment to be tailored to both the patient and the wound. The aim of this study is to review the various options for soft tissue reconstruction of complete circumferential defects in the upper extremity.
Methods A literature review of PubMed and MEDLINE up to December 2016 was performed. The current study focuses on forearm and arm defects from the level at or proximal to the wrist and were assessed based on Tajima's classification (J Trauma 1974). Data reviewed for analysis included patient demographics, causality, defect size, reconstructive technique(s) employed, and postoperative follow-up and functional outcomes (when available).
Results In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 14 unique articles were identified for a total of 50 patients (mean=28.1 years). Underlying etiologies varied from extensive thermal or electrical burns to high impact trauma leading to degloving or avulsion, crush injuries, or even occur iatrogenically after tumor extirpation or extensive debridement. Treatment options ranged from the application of negative pressure wound dressings to the opposite end of the spectrum in hand transplantation.
Conclusions With the evolution of reconstructive techniques over time, the extent of functional and aesthetic rehabilitation of these complex upper extremity injuries has also improved. The proposed management algorithm comprehensively addresses the inherent challenges associated with these complex cases. |
| first_indexed | 2024-12-10T06:45:54Z |
| format | Article |
| id | doaj.art-fca2f8ca398d4c4ca1df7de8c12359ba |
| institution | Directory Open Access Journal |
| issn | 2234-6163 2234-6171 |
| language | English |
| last_indexed | 2024-12-10T06:45:54Z |
| publishDate | 2017-03-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Archives of Plastic Surgery |
| spelling | doaj.art-fca2f8ca398d4c4ca1df7de8c12359ba2022-12-22T01:58:41ZengThieme Medical Publishers, Inc.Archives of Plastic Surgery2234-61632234-61712017-03-01440211712310.5999/aps.2017.44.2.117771Soft Tissue Reconstruction of Complete Circumferential Defects of the Upper ExtremityZhi Yang Ng0Shaun Shi Yan Tan1Alexandre Gaston Lellouch2Curtis Lisante Cetrulo Jr3Harvey Wei Ming Chim4Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, MA, USARoyal College of Physicians and Surgeons of Glasgow, Scotland, UKDivision of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, MA, USADivision of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, MA, USADivision of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL, USABackground Upper extremity soft tissue defects with complete circumferential involvement are not common. Coupled with the unique anatomy of the upper extremity, the underlying etiology of such circumferential soft tissue defects represent additional reconstructive challenges that require treatment to be tailored to both the patient and the wound. The aim of this study is to review the various options for soft tissue reconstruction of complete circumferential defects in the upper extremity. Methods A literature review of PubMed and MEDLINE up to December 2016 was performed. The current study focuses on forearm and arm defects from the level at or proximal to the wrist and were assessed based on Tajima's classification (J Trauma 1974). Data reviewed for analysis included patient demographics, causality, defect size, reconstructive technique(s) employed, and postoperative follow-up and functional outcomes (when available). Results In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 14 unique articles were identified for a total of 50 patients (mean=28.1 years). Underlying etiologies varied from extensive thermal or electrical burns to high impact trauma leading to degloving or avulsion, crush injuries, or even occur iatrogenically after tumor extirpation or extensive debridement. Treatment options ranged from the application of negative pressure wound dressings to the opposite end of the spectrum in hand transplantation. Conclusions With the evolution of reconstructive techniques over time, the extent of functional and aesthetic rehabilitation of these complex upper extremity injuries has also improved. The proposed management algorithm comprehensively addresses the inherent challenges associated with these complex cases.http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2017.44.2.117upper extremityreconstructive surgical proceduressoft tissue injuries |
| spellingShingle | Zhi Yang Ng Shaun Shi Yan Tan Alexandre Gaston Lellouch Curtis Lisante Cetrulo Jr Harvey Wei Ming Chim Soft Tissue Reconstruction of Complete Circumferential Defects of the Upper Extremity Archives of Plastic Surgery upper extremity reconstructive surgical procedures soft tissue injuries |
| title | Soft Tissue Reconstruction of Complete Circumferential Defects of the Upper Extremity |
| title_full | Soft Tissue Reconstruction of Complete Circumferential Defects of the Upper Extremity |
| title_fullStr | Soft Tissue Reconstruction of Complete Circumferential Defects of the Upper Extremity |
| title_full_unstemmed | Soft Tissue Reconstruction of Complete Circumferential Defects of the Upper Extremity |
| title_short | Soft Tissue Reconstruction of Complete Circumferential Defects of the Upper Extremity |
| title_sort | soft tissue reconstruction of complete circumferential defects of the upper extremity |
| topic | upper extremity reconstructive surgical procedures soft tissue injuries |
| url | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2017.44.2.117 |
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