Treatment of Traumatic Degloving Injuries of the Fingers and Hand

作者：Shahram Nazerani, Mohammad Hosein Kalantar Motamedi, Tara Nazerani, Bardia Bidarmaghz · 发表于：Techniques in Hand and Upper Extremity Surgery · 年份：2011 · DOI：10.1097/bth.0b013e3182051c02 · 被引用次数：19 · 研究领域：Reconstructive Surgery and Microvascular Techniques、Burn Injury Management and Outcomes、Reconstructive Facial Surgery Techniques

BACKGROUND: Degloving injury of the hand and fingers is one of the most severe and debilitating hand injuries and an operation of choice is yet to be found. In this study, we introduce a modified abdominal flap, the "compartmented abdominal flap," for coverage of degloving injuries of the fingers and hand. The flaps reported up to now are diverse, and 2 or even 3 flaps in 1 session have been used to cover the hand and fingers. Often, the flaps used have mismatching colors and the donor defect is huge when 2 large flaps are used in 1 setting. In this study, we present a 1-flap solution to treat degloving injuries of the hand and fingers. METHOD: The compartmented abdominal flap was used in 6 patients with different hand and/or finger degloving injuries, which were covered by a 1-flap procedure. The single flap is designed in 2 layers: the flap that is an abdominal flap is elevated as usual and at the next stage of dissection, we create a separate compartment for each finger in the superficial fatty layer of the skin flap making pockets that encircle each finger separately. An external fixator device is placed to hold the fingers in their respective pockets. The flap is severed in 3 to 4 weeks time in a serial manner. The volar surface of the fingers, which is covered by fatty tissues by then, is skin grafted at a later date. RESULTS: All the flaps survived and the contour of the hand and sensation was superior to the earlier flaps reported in the literature and in our earlier ...