Related Experiment Video
Updated: Nov 8, 2025
08:11
Vascularized Composite Upper Limb Allograft Harvesting for Proximal Arm Allotransplantation
Published on: June 13, 2025
295
Thirty-Day Outcomes following Upper Extremity Flap Reconstruction
Thomas Wright1, Daniel Donato2, Jacob Veith1
1Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States.
Journal of Hand and Microsurgery
|April 19, 2021
Summary
Flap reconstruction for upper extremity defects presents challenges. Key factors like American Society of Anesthesiologists (ASA) classification, bleeding disorders, and wound type impact complication rates, necessitating careful surgical planning.
Area of Science:
- Plastic Surgery
- Surgical Outcomes Research
Background:
- Upper extremity flap reconstruction is complex.
- Understanding risk factors for complications is crucial.
Purpose of the Study:
- To identify preoperative and perioperative variables associated with complications in upper extremity flap reconstructions.
- To analyze outcomes of free flap reconstructions in the upper extremity.
Main Methods:
- Utilized the National Surgical Quality Improvement Program (NSQIP) database (2005-2016).
- Analyzed patient and perioperative data for flap reconstructions of upper extremity defects.
- Assessed associations between variables and complication rates using multivariate analysis.
Main Results:
- American Society of Anesthesiologists (ASA) classification >2, bleeding disorders, steroid use, and non-clean wounds increased overall complications.
- Major complications were linked to bleeding disorders, ASA >2, male gender, non-clean wounds, and anemia.
- Free flap reconstruction correlated with longer hospital stays, operative times, and higher complication rates.
Conclusions:
- Complications in upper extremity flap reconstruction are associated with ASA classification >2, anemia, steroid use, bleeding disorders, and contaminated wounds.
- Male patients may need enhanced counseling regarding activity restrictions post-reconstruction.
- Free flap procedures for upper extremity defects require meticulous planning to mitigate risks.
