Soft tissue coverage of the hand and wrist

PURPOSE OF REVIEW: Soft tissue defects in the hand and wrist pose a challenging problem for surgeons involved in their care. A variety of local and regional flaps, as well as free tissue transfer options have been described. All of these are useful, but we are still searching for simpler, more reliable solutions. In this review, we discuss some of the recent advancements and remaining challenges in reconstructing soft tissue defects around the hand and wrist. RECENT ADVANCES: Current research and clinical studies have been directed towards improving sensation, minimizing donor site deformity, and refining the aesthetic outcome after reconstructive surgery. Variations of previously described techniques have recently improved our ability to reconstruct soft tissue injuries to the fingertip as well as the dorsal aspect of the digits. The use of dermal substitutes has simplified reconstruction of complex wounds around the hand and wrist while minimizing donor sites, and ongoing research in tissue engineering will enable us to find new solutions for complex reconstructive problems. SUMMARY: The increased use of innervated flaps for fingertip reconstruction, dermal substitutes for hand reconstruction, and future research in the field of tissue engineering, will undoubtedly lead to improved results in all aspects. © 2007 Lippincott Williams & Wilkins, Inc.

Duke Scholars

Author Warren Hammert Orthopaedic Surgery