1 research outputs found
Bilateral reconstruction of palmar soft tissues defects of the hands after thermal injury
Introduction Thermal injury to the palmar surface of the hand is usually complicated by flexion desmogenic
contracture of the finger joints. This condition is more complicated with significant wound areas and depths
of soft tissue destruction. Conventional surgical methods and soft tissue reconstructions may fail to provide
full restoration of the hand function.
The objective was to present the optimal treatment strategy for patients with scar flexion contractures
of the fingers after thermal injury to the palmar surface of both hands using a pediatric case report.
Material and methods A child aged 2 years and 4 months underwent surgical treatment to include excision
of scars, skin grafting of both hands with a vascularized fasciocutaneous flap raised with the radial artery.
Result The patient could regain all types of hand grip on both sides 12 years after surgical treatment.
Both hands were aesthetically acceptable.
Discussion Treatment of patients with thermal injury and substantial soft tissue damage is a complex disease
process. Conservative treatment and surgical procedures using non-vascularized skin flaps are normally
used for the condition. These approaches are associated with cicatricial and arthrogenic flexion contracture
of the finger joints. The radical treatment includes thorough wound debridement and early flap coverage and
wound closure using a flap with an axial-pattern blood supply, free flaps and reverse-flow flaps. The surgical
approach helps to avoid flexion contracture of the fingers initiating early restoration of professional, social
stereotypes and stereotypes in everyday life.
Conclusion The clinical observation has shown the possibility of one-stage organ-preserving surgical
treatment using flaps with an axial blood supply