Reconstruction to the upper limb may involve:
Local flap reconstruction
The use of the “next best skin” being the next best skin. Flaps can be mobilised from adjacent tissue as pivot, advancement or interpolation flaps.
Regional flap reconstruction
Reliable tissue can be transferred based on the vascular pedicles of the upper limb. This tissue is used to resurface areas of tissue loss.
Distant flap reconstruction
Areas adjacent to the upper limb can be used to resurface larger defects in the upper limb. Such areas include the groin, abdomen and chest. These techniques may involve 2 staged operations.
Free flap reconstruction
More complex defects require the use of free tissue transfer. This is where a reliable block of tissue is moved from one area to another and its blood supply is restored using microsurgical techniques.
Revascularisation and replantation
Microsurgical reconstruction is used to restore a blood supply to a region when it has been divided (e.g. severed digit), or to restore blood flow when interrupted by trauma (e.g. crush injury).
Complications and Risks
All Procedures have potential complications and risks. These can be divided into general complications and those specific to each procedure. The latter are listed in the FAQs below.
General complications include:
- Wound complications - bleeding, bruising, collections under the skin of blood (haematoma), pus (abscess), serous fluid (seroma), infection, wound breakdown, suture extrusion, sensory loss;
- Aesthetic complications - poor scars, stretched scars, raised scars (keloid or hypertrophic), contour irregularities, need for revisional procedure;
- Anaesthetic complications