Summary
Reconstruction of complex extremity trauma continues to be a challenging task for
plastic surgeons. Characteristics of such injuries include destruction of functional
structures, often due to high energy trauma that causes significant invalidity. Before
the era of free flaps, pedicled fasciocutaneous and muscle flaps were the only option
for reconstruction of the severely injured upper extremity. The management of complex
injuries of the upper extremity has changed with the development of reconstructive
microsurgery.
Nowadays, we have a great variety of different free flaps to cover defects of the
upper extremity and restore function by innervated free flaps. Sensibility, skin thickness,
texture, colour, durability, binding of the flap to the underlying structures, donor
site morbidity, possibility of secondary reconstructive procedures, the surgeon's
experience and operative facilities must all be taken into consideration for choosing
the optimal reconstructive procedure. Not only the reconstructive und functional requirements
but the timing of reconstruction is extremely important for final result.
The purpose of this paper is to define the principles of flap selection and timing
of flap reconstruction, according to the assessment of trauma in the upper limb.
Keywords
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Article info
Publication history
Published online: May 30, 2007
Accepted:
March 7,
2007
Received:
December 10,
2006
Identification
Copyright
© 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
