Introduction: Hand injuries are the most complex injuries when compared to other bodily injuries. A better understanding of the biological, behavioral, and socioeconomic risk factors that are associated with hand injuries is therefore needed. This data can help identify individuals at risk and define preventive measures to help reduce the incidence. Material and Methods: We present a study of 350 consecutive patients of hand injury treated between 2017- 2018. The demographic profile of the patient along with the type & cause of the injury sustained, hand dominance, type of procedure, and requirement of hospital administration was extracted from hospital records. Results: 159 (45.5%) of the patients were in the age group of fewer than 20 years. Out of the 350 patients, 288 (82%) were male. 302 (86%) patients were right-handed. The most common mode of injury was machine injury in 205 (59%) patients. 181 (52%) patients had crush injury, 107 (31%) had the sharp cut injury, and 32 (9%) had blast injury. 94 (27%) patients needed hospital admission for management. 119 ( 34%) patients had the injury to the thumb, 89 (25%) had injury to the middle finger. Primary suturing was done in 116 (33%) patients, tendon and nerve repair in 209 (60%), and 177 (51%) patients respectively. Conclusions: The study describes the demography and etiology of the cases of hand injury. The study has a limitation of having absence of assessment of functional outcome. There is a necessity of hand trauma registry to quantify the burden of hand injuries and formulate a prevention strategy at the national level.
Introduction Reconstruction forms the primary tenet in plastic surgery. Venous flaps are a known option but the survival is limited. Arterialization of venous flap can enhance its survival. While various techniques of arterialization of venous flaps are described, there are very few studies comparing them. Material and methods The current study was conducted among 34 rats weighing 160 to 200 grams. The rats were divided into four groups. Group I—islanded epigastric flap was raised with superficial caudal epigastric vessels as pedicle. Group II—arterialized flow through venous flap was raised with superficial caudal epigastric vein (SCEV) as afferent and lateral thoracic vein as drainage vein. Side-to-side anastomosis was done between femoral artery and vein, lateral to the origin of superficial caudal epigastric artery. Group III—after raising the flap, as in group II, femoral vein was ligated proximal to superficial caudal epigastric vessels. Group IV—an arterialized flow through venous flap was raised with superficial caudal epigastric vein as afferent and lateral thoracic vein as drainage vein. End-to-side anastomosis was done between femoral artery and superficial caudal epigastric vein. Animals that died before completion of the study were excluded. The color changes of flaps were noted. Flap survival was expressed as a percentage of the total flap surface area. The patency of anastomosis was seen on postoperative day 5. Results There was no total flap failure. On statical analysis, the flap survival area on day 5 between Group I and Group IV was not significant (p value 0.431). The survival area in Group I (78.85 ± 10.54%) was comparable to Group IV (65.71 ± 20.70%). Group II and III had poor results as compared with Group I. In four rats, thrombosis of arteriovenous anastomosis was noted with flap survival area of 30 to 33%. Conclusion It was noted that epigastric venous flaps with end-to-side anastomosis between femoral artery and superficial caudal epigastric vein (group IV) have survival area comparable to islanded flaps.
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