Flap Selection Approach for Hand Soft Tissue Defects Reconstruction: Surgical Techniques and Outcome Evaluation

Abstract

Background: The hand is an intricate part of the body that plays an essential role in social functioning, expression, productivity, and interactions with our environment.Many flap options have been described to address the specific functional and anatomic requirements in soft tissue reconstruction of the hand. The aim of this study isto find the ideal donor tissue for coverage of soft tissue defects of the hand to achieve wound closure and maintain joint and hand function. Patients and methods: A prospective study wasconducted betweenfrom April 2018 and May 2019, on all patients with soft tissue defects of the hand presented to plastic surgery department, Qena faculty of medicine,South Valley University. Results:There were 62 hand injuries in 50 patients with a mean age of 35 years (range, 1- 69 years). The etiologies of the injuries were mostly due to post-traumatic raw areas (86%). In our study we divided cases into 4 main groups, the first group including fingertip injuries, second group proximal to fingertips, third group palm and fourth group dorsum of the hand. The distribution of the hand injuries were 48 fingertips injury, 8 injuries proximal to fingertips, palm injury in one patient and injuries over hand dorsum in 5 patients.The follow up period was ranged 1 to 6 months. Conclusion:An algorithmic approach for coverage of the hand soft tissue defect seems to provide predictable results regarding flaps survival and preservation of finger length.

Keywords

• hand; fingertip; reconstruction; flaps