[Microsurgical plastic reconstruction of the explosion-damaged hand]

During the last two years, 16 severe explosion injuries of the hand have been treated with plastic microsurgery in our hospital. The injury had arisen in seven cases from the mixture sugar + sodium chlorate (C12H22O11 + NaClO3). This substance mixture may already be caused to explode by slight vibrations and the warmth of the hands. In explosion injuries, there is mechanical, chemical and thermal tissue damage. The postoperative course is therefore complicated in almost all cases. However, by meticulous removal of the disseminated foreign particles, excision of necrotic tissue and extensive reconstruction of the interrupted vascular and nerve supply, it is possible in a few cases to preserve functionally important parts of the hand. Later plastic procedures are made more difficult by tissue fibrosis and foreign body granulomas.