Plastic Reconstruction of Upper Extremity Defects in Necrotizing Soft Tissue Infections

Area of Science:

• Orthopedics
• Plastic Surgery
• Infectious Diseases

Background:

• Necrotizing soft tissue infections (NSTIs) of the upper extremity present complex reconstructive challenges due to large defects and exposed critical structures.
• Effective management necessitates prompt source control and debridement followed by appropriate soft tissue reconstruction.

Purpose of the Study:

• To review the principles and options for soft tissue reconstruction in patients with upper extremity NSTIs.
• To discuss factors influencing reconstructive method selection and patient outcomes.

Main Methods:

• Review of current literature and established reconstructive techniques for upper extremity soft tissue defects following NSTIs.
• Consideration of patient-specific factors including defect size, exposed structures, comorbidities, and physiological status.

Main Results:

• Soft tissue reconstruction options range from local wound care and dermal substitutes to local, distant pedicled, and free flaps.
• Dermal substitutes can facilitate wound bed preparation for subsequent skin grafting.
• The choice of reconstruction depends on defect characteristics and patient condition.

Conclusions:

• Successful soft tissue reconstruction following upper extremity NSTIs is achievable with various surgical modalities.
• Patient-specific factors are crucial in selecting the optimal reconstructive approach.
• Good functional outcomes can be expected after appropriate reconstruction.