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Vascularized Composite Upper Limb Allograft Harvesting for Proximal Arm Allotransplantation

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Hand amputations: epidemiology, management and resurfacing options for soft tissue coverage.

M F Khurram¹, Z Masoodi¹, M Yaseen¹

¹All at the Department of Burns, Plastic and Reconstructive Surgery, JN Medical College, AMU, Aligarh, India.

Journal of Wound Care

|October 22, 2015

Summary

Agricultural hand injuries disproportionately affect young Indian adults, often leading to work impairment. Prompt surgical reconstruction, particularly with forearm flaps, can improve outcomes and reduce hospital stays.

Keywords:

agriculture hand injuries hand amputation soft tissue reconstruction stump resurfacing

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Area of Science:

Orthopedics
Trauma Surgery
Epidemiology

Background:

Agricultural hand injuries are a significant concern, particularly affecting young adults and impacting their socioeconomic well-being.
These injuries often result in loss of function in the dominant hand, hindering work and social activities.

Purpose of the Study:

To investigate the epidemiology of agricultural hand injuries in Indian subjects.
To analyze the management strategies and outcomes of these injuries.

Main Methods:

A retrospective study was conducted in India from October 2009 to December 2013.
Data on socio-demographics, injury type, surgical reconstruction, complications, and hospital stay were collected and analyzed.

Main Results:

Young adults of lower socioeconomic status were most affected, with injuries often occurring during harvest seasons.
Wheat thresher injuries (51%) and fodder cutting machine injuries (36%) were the most common causes, particularly among females and children.
Reverse radial forearm flaps were optimal for regional coverage, while thoraco-umbilical flaps were common distant flaps; single-stage procedures shortened hospital stays.

Conclusions:

While not entirely preventable, agricultural hand injuries can be reduced through education, though socioeconomic factors pose challenges.
Forearm flaps are versatile for hand reconstruction, promoting early discharge and rehabilitation.
Abdominal flaps serve as effective coverage for associated forearm injuries.