Flap transfer for traumatic defects of the upper extremity: experience of 35 cases

Abstract Background Despite advances in microsurgical techniques of flap transfer, complex upper extremity trauma reconstruction remains a challenge for surgeons. Methods We retrospectively analyzed data from patients undergoing subacute upper extremity flap reconstruction, including flap choices, complications and success of flap reconstructions. Results Thirty-five patients underwent free flap procedures, including 24 anterolateral thigh flaps (68.57%), five latissimus dorsi flaps (14.29%) and six lateral arm flaps (17.14%). Flap sizes ranged from 3 × 4 to 33 × 11 cm 2 . The mean time of flap reconstruction was 14 days (range 5–29). Two flaps developed partial necrosis, both of which were later treated with skin-grafting. Traumatic wound infections occurred in three patients. All upper limb trauma was completely covered. Conclusions All three types of skin flaps used to reconstruct severe upper limb soft tissue defects achieved satisfactory function and appearance with negligible complications and low amputation rates during the subacute period.