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Mutilating hand injuries: principles and management.
Michael W Neumeister1, Richard E Brown
1Southern Illinois University Plastic Surgery, PO Box 19653, Springfield, IL 62794, USA. mneumeister@siumed.edu
Hand Clinics
|April 10, 2003
Summary
Treatment for severe hand injuries focuses on survival and function. Key steps include initial stabilization, thorough cleaning, and surgical repair, with further procedures to restore dexterity and enable return to work.
Area of Science:
- Orthopedic Surgery
- Trauma Care
- Hand Surgery
Background:
- Mutilating hand injuries present complex challenges requiring a multi-stage treatment approach.
- Ensuring patient survival, limb salvage, and functional restoration are paramount objectives.
Observation:
- Initial management involves patient stabilization, thorough wound irrigation, and debridement.
- Surgical interventions include skeletal stabilization, revascularization, replantation, or grafting for immediate functional restoration.
Findings:
- Multiple surgical procedures, including second or third look operations, may be necessary for wound bed preparation.
- Soft tissue coverage is achieved through regional flaps or free tissue transfer.
- Secondary procedures like tenolysis, joint mobilization, and toe transfers are crucial for restoring hand dexterity.
Implications:
- Adherence to established surgical principles minimizes further morbidity.
- Successful treatment facilitates the restoration of hand function, enabling patients to return to gainful employment and daily activities.