Management of a mutilated hand: the current trends

S. Raja Sabapathy, Francisco del Piñal, Martin I. Boyer, Dong Chul Lee, Sandeep Jacob Sebastin, Hari Venkatramani

Research output: Contribution to journalReview articlepeer-review

Abstract

Mutilated upper limbs suffer loss of substance of various tissues with loss of prehension. The most important factor in salvage of a mutilated hand is involvement of a senior surgeon at the time of initial assessment and debridement. A regional block given on arrival helps through assessment and investigations in a pain-free state. Infection still remains the important negative determinant to outcome and is prevented by emergent radical debridement and early soft tissue cover. Radical debridement and secure skeletal stabilization must be achieved on day one in all situations. Dermal substitutes and negative pressure wound therapy are increasingly used but have not substituted regular soft tissue cover techniques. Ability to perform secondary procedures and the increased use of the reconstructed hand with time keeps reconstruction a better option than prosthesis fitting. Toe transfers and free functioning muscle transfers are the two major secondary procedures that have influenced outcomes.

Original languageEnglish
Pages (from-to)98-104
Number of pages7
JournalJournal of Hand Surgery: European Volume
Volume47
Issue number1
DOIs
StatePublished - Jan 2022

Keywords

  • limb salvage
  • mangled extremity
  • microsurgical hand reconstruction
  • Mutilated hand

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