title: Resurfacing of a totally degloved hand using thin perforator-based cutaneous free flaps.
abstract: Resurfacing after a total degloving injury to the hand is one of the most difficult management problems in hand surgery. Although there are many methods of managing this type of injury that preserve functions and lessen deformities, none provides a satisfactory solution to this problem. The authors resurfaced a totally degloved hand using extremely thin and broad perforator-based cutaneous free flaps, and the donor defects were covered with split-thickness skin grafts. The postoperative course was uneventful, the flaps survived completely, and the grafts took without loss. Several minor operations, including interdigitation, defatting, and the formation of palmar and digital creases, were required to obtain the final appearance and function of the hand. Eighteen months after the initial operation, the patient could pick up a bean with a pair of chopsticks. Sensation was satisfactory in the palm 20 months after the initial operation, as evidenced by 10 mm of static two-point discrimination. To reconstruct a total and complete skin defect of the hand, the authors recommend that thin perforator-based cutaneous free flaps be an initial consideration.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Kwanju, Korea.
authors.forename: Kwang Seog
authors.initials: KS
authors.lastname: Kim
authors.forename: Eui Sik
authors.initials: ES
authors.lastname: Kim
authors.forename: Dae Young
authors.initials: DY
authors.lastname: Kim
authors.forename: Sam Yong
authors.initials: SY
authors.lastname: Lee
authors.forename: Bek Hyun
authors.initials: BH
authors.lastname: Cho
mesh_terms: D000328:Adult; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods; D016038:Skin Transplantation; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply