Replantation of Severed Fingers with Soft-Tissue Defects
With the development of industry and agriculture, and diversification of the automatic machine, there are and increasing number of types of severed fingers including those with soft-tissue defects. Soft-tissue defects include defect of the skin, vessels, and nerves, and there is a lack of a regular method for repair because of the complicated conditions, the variety of injuries, and variety of ways to repair them. Professional microsurgical techniques and a knowledge of flaps are required for surgeons so that they choose a suitable flap for repair according to the type of injury and the extent, position, and scope of the defect. Soft-tissue defect was listed as a contraindication for replantation in the 1980s. The replantation used to be applied by shortening bones that would survive, but without satisfactory appearance and function. Sometimes, to preserve the joints and length of the fingers, palliative debridement may cause infection, necrosis of the skin, and poor blood supply, which will affect finger survival or the finger survives, but the functioning is affected by the shortened finger, poor sensation, severe tendon adhesion, and stiff joints. With the development of microsurgery techniques and the maturity of flaps, vessels, tendons, flaps, and composite tissue flaps can be used to repair the soft-tissue defects of severed fingers to reduce postoperative vascular crisis, increase the survival rate, and expand the indications for replantation.
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