Clinical application of composite tissue transfer in the management of mutilated hand injuries

Abstract

Objective To explore the techniques of composite tissue transplantation in the treatment of mutilated hand injuries.Methods From October 1996 to October 2011,185 cases of mutilated hand injuries were treated.They were treated by one-stage composite tissue transfer including the wrap-around flap from the big toe,the second toe,the anterolateral thigh flap and dorsalis pedis flap.Results All 341 pieces of transferred tissue components in 185 patients survived.According to the functional assessment criteria of the upper limb formulated by the Hand Surgery Society of Chinese Medical Association,the outcomes of 60 reconstructed thumbs were graded as excellent,33 thumbs as good and 16 thumbs as fair.The results of 87 reconstructed fingers were graded as excellent,114 fingers as good,23 fingers as fair and 8 fingers as poor.Conclusion Composite tissue transfer can restore the function and appearance of a mutilated hand in one stage and is a good method to treat mutilated hand injuries. Key words: Hand injuries; Microsurgery; Composite tissue transplantation