Soft and tissue repair of the hand and digital reconstruction

Abstract

This article summarizes the current views and proposed approaches to treating soft tissue defects of the hand. The article also outlines some key considerations of digital reconstruction. There are many options in treating soft tissue defects. For defects of the hand, local flaps are primarily considered if the defects are small or moderate in size. A vascularized free flap is only considered for a defect of large size (3 cm long or larger). Thumb reconstruction is of primary importance, while reconstruction of two fingers is necessary when all fingers are lost. Reconstructions of a missing distal part of a finger or reconstruction of an entire finger if only one finger is lost are cosmetic restorations; functionally these defects do not need reconstruction. Sensation is of great importance in repair or reconstruction of the tip of the thumb or finger. Therefore, sensory evaluation is a key factor in assessing and selecting the best options of surgery.

Der heterodigitale neurovaskuläre Insellappen nach Littler: Zur Erstautorenschaft sowie eigene Erfahrungen

“…Der heterodigitale neurovaskuläre Lappen [17] wird in seiner ursprünglichen Form aufgrund von Problemen mit dem Hebedefekt zumindest für Rekonstruktionen außer am Daumen von einigen Autoren [31,43] als nicht indiziert gesehen oder gänzlich abgelehnt. Einige der diversen Modifikationen des Lappens, wie die von uns bevorzugte Variante -der dorsale Mittelglied-Lappenzeigen eine sehr geringe Morbidität am Hebefinger und können vielseitig eingesetzt werden [21][22][23].…”

Clinical outcomes of a novel porcine small intestinal submucosa patch for full-thickness hand skin defects: a retrospective investigation

“…As hand is one of the most frequently used extremity when manipulating machines, high rate of injury that caused by various injury mechanisms makes it more vulnerable [ 1 , 2 ]. Soft tissue defects of the hand require systematized methods to restore the function and aesthetic appearance [ 3 , 4 ]. As stable skin supply and soft tissue coverage are regarded as the primary goal during the reconstruction of mutilated hands, essential consideration on these aspects during surgical planning is getting more and more attention [ 5 ].…”

Beauty and Function: The Use of Trimmed Great Toe in Thumb and Finger Reconstruction

“…Local flaps, such as homodigital and heterodigital flaps, [7][8][9][10] pedicled hand and forearm flaps, or thin free flaps, 11,12 are commonly used to replace the loss of substance. However, these procedures do not restore the injured finger's original length and tissue complexity, resulting in poor functional and cosmetic outcomes.…”