Soft Tissue Reconstruction of Upper Limb Injuries in Southwestern Nigeria: Methods and Outcome

Upper limb injuries requiring soft tissue coverage are common in our environment. These reconstructions provide protection for vital structures and enable tendon gliding. Despite the frequency of these, there is a lack of data on the scope of soft tissue reconstruction and outcomes in our subregion.

To demonstrate the scope and outcome of soft tissue reconstruction of upper limb injuries, we conducted a study at a major plastic surgery service in Southwestern Nigeria.

This study employed a cross-sectional analytic approach, focusing on all patients with upper limb injuries requiring soft tissue reconstruction between April 2022 and March 2023.

During the study period, a total of 49 patients underwent soft tissue reconstruction for upper limb injuries, with a mean age of 36.4 ± 11.3 years. The majority were male (n = 40, 81.6%). The methods of reconstruction included flaps (51%, n = 25) of cases, direct closure (36.7%, n = 18), and skin grafting (12.3%, n = 6). Among flap options, local flaps were utilized in 48% (n = 12), regional flaps in 32% (n = 8), and distant flaps in 20% (n = 5). The median time from injury to surgery, surgery to discharge, and length of hospital stay are 6 days, 6 days, and 13 days, respectively. Patients undergoing local flaps had a shorter injury-to-surgery time compared to those receiving regional and distant flaps (P = 0.026). Patients undergoing skin grafting, regional flaps, and distant flaps experienced longer hospital stays compared to those with direct closure and local flaps (P = 0.000). The in-patient complication rate was 14.3%.

The methods of soft tissue reconstruction for upper limb injuries in our institution include flaps, skin grafting, and direct closure.