title: Emergency free tissue transfer for severe upper extremity injuries.
abstract: 29 patients with severe upper extremity injury were treated with 27 emergency free flap and three emergency toe-to-hand transfers, after radical débridement and primary reconstruction of all injured structures. There was no flap failure, and no infections or wound-healing complication were seen. Follow-up ranged from 3 months to 6.6 years with a mean of 3.2 years. 19 patients returned to work (14 to their original jobs), three were retired and another seven had no employment before injury. Operation time ranged from 2 hours 45 minutes to 18 hours 20 minutes with an average of 7 hours 45 minutes, depending upon the size of the defect and mechanism of injury. Long-term follow-up revealed successful functional and aesthetic results, decreased morbidity and invalidity, and reduced rates of free flap failure, post-operative infection, secondary operative procedures, hospital stay and medical expense.
authors.affiliation: University Hospital of Plastic and Reconstructive Surgery, Innsbruck, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Ninkovic
authors.forename: H
authors.initials: H
authors.lastname: Deetjen
authors.forename: K
authors.initials: K
authors.lastname: Ohler
authors.forename: H
authors.initials: H
authors.lastname: Anderl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003646:Debridement; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006230:Hand Injuries / Q000209:etiology / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps / Q000379:methods*; D013997:Time Factors; D016378:Tissue Transplantation / Q000379:methods; D016896:Treatment Outcome