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The pre-procedure steps of handwashing include removing jewelry and rolling up sleeves. However, many organizations allow staff to wear wedding rings.
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Current Principles in the Management of a Mangled Hand.

Martina Macrì1, Pierfrancesco Pugliese2, Graziano Accardo2

  • 1UOC Chirurgia della Mano e Microchirurgia Ricostruttiva - ASST Gaetano Pini - CTO, Milano, Italy.

Journal of Hand Surgery Global Online
|April 4, 2025
PubMed
Summary

Mangled upper-extremity injuries require prompt assessment and management. Early surgical intervention and reconstruction aim to restore hand function and improve patient quality of life.

Keywords:
Mangled handReconstructive microsurgeryReplantationRevascularization

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Area of Science:

  • Orthopedic Surgery
  • Trauma Care
  • Hand Reconstruction

Background:

  • Mangled upper-extremity injuries present significant challenges, impacting patient quality of life.
  • Effective treatment necessitates early and precise management strategies.

Purpose of the Study:

  • To outline treatment guidelines for mangled hand injuries.
  • To present a step-by-step approach for surgical reconstruction.

Main Methods:

  • Initial assessment in the emergency department to quantify injury and evaluate amputated segments for replantation or tissue banking.
  • Careful surgical debridement in the operating room as a critical step for reconstruction.

Main Results:

  • Reconstruction aims to achieve a functional hand with at least three sensitive, opposable fingers.
  • Adherence to established guidelines and a systematic approach are key to successful outcomes.

Conclusions:

  • Early management and meticulous surgical technique are crucial for successful mangled hand reconstruction.
  • The presented approach facilitates achieving acceptable functional results and improving patient quality of life.