title: Case report: sequential vascular connection of free flaps in the upper extremity.
abstract: Devastating hand injuries often require multiple microvascular reconstructions. We report a patient in whom two flaps were used for late reconstruction of a devastating hand injury involving devascularization of the right hand, severely comminuted fractures of the hand and forearm, and multiple tendon avulsions. We believe the sequential vascular connection of free flaps offers the best method of reconstruction in this severe case, allowing composite tissue transfer, monitoring of the osseous flap, and optimal positioning of the two free tissue transfers.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Medical College of Wisconsin, Milwaukee 53226, USA.
authors.forename: W W
authors.initials: WW
authors.lastname: Dzwierzynski
authors.forename: J R
authors.initials: JR
authors.lastname: Sanger
authors.forename: N J
authors.initials: NJ
authors.lastname: Yousif
authors.forename: H S
authors.initials: HS
authors.lastname: Matloub
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D016025:Bone Transplantation / Q000379:methods; D016267:External Fixators; D005260:Female; D005543:Forearm Injuries / Q000601:surgery*; D018460:Fractures, Comminuted / Q000601:surgery; D005599:Fractures, Ununited / Q000601:surgery; D006225:Hand / Q000098:blood supply; D006801:Humans; D008866:Microsurgery / Q000379:methods*; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D013524:Surgical Flaps / Q000098:blood supply*; D017535:Ulnar Artery / Q000601:surgery; D014680:Veins / Q000601:surgery; D014954:Wrist Injuries / Q000601:surgery*