Soft tissue coverage in devastating hand injuries.
Plastic surgical therapy of mutilating hand injuries represents a multifaceted task to the hand surgeon, where considerations about indication, timing, and structure of the soft tissue coverage play a major role in reconstruction. The concept of early primary reconstruction (including emergency procedures) and fast rehabilitation not only demands thoughtful tissue preparation but also mastering of a bandwidth of plastic surgical techniques. Systematic algorithms based on the reconstructive ladder help in decision making in the complexity of soft tissue coverage but have to be adjusted to the individual case profile. General considerations and strategic planning are explained and illustrated by three clinical cases.
Giessler
Goetz A
GA
Department for Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic & Hand Surgery, University of Heidelberg, Ludwig-Guttmann-Strasse 13, 67071 Ludwigshafen, Germany. giessler@hotmail.com
Erdmann
Detlev
D
Germann
Guenter
G
D000328:Adult; D000465:Algorithms; D004210:Dissection; D005260:Female; D005383:Finger Injuries / Q000601:surgery; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery; D019651:Plastic Surgery Procedures; D017695:Soft Tissue Injuries / Q000601:surgery; D013524:Surgical Flaps