Analysis of unsatisfactory outcomes and complications when choosing tactics of treatment in patients with extensive defects of the soft tissue of the brush

The aim of the study was to analyze unsatisfactory outcomes and complications of treatment of patients with extensive soſt tissue defects of the hand.

Material and methods. The analysis of the treatment of 138 patients with extensive defects of the soſt tissues of the hand, with various types of skin graſting and with conservative methods. patients were divided into two groups: main (60), with soſt tissues of the injured hand with an axial type of blood supply flaps. The second group (44 patients) who used local tissue plastic and free skin plastic (split or full-layer) to close extensive soſt tissue defects of the hand. In 34 cases, wound defect healing was carried out by conservative methods (group 3).

Results. The structure of unsatisfactory outcomes and complications was dominated by contracture of the fingers joints with desmogenic and tenogenic origin, sensitivity and trophic disorders. The functional results of the upper limb studied according to DASH scales, the assessment of the quality of life according to the SF-36. A comparative assessment of anatomy, amplitude of movements in the fingers (flexion and extension), dynamometry and the state of the main types of grip carried out. At the same time, it was revealed that in the long-term period aſter surgery, the indicators significantly improved in both groups (p<0.01), but a statistically significant difference between the groups was also revealed in favor of the group of patients operated using vascularized flaps with an axial type of blood supply.> < 0.01), but a statistically significant difference between the groups was also revealed in favor of the group of patients operated using vascularized flaps with an axial type of blood supply.

Conclusion. A high proportion of unsatisfactory results of reconstruction of soſt tissues of the hand by traditional techniques, leading to a significant decrease in the functionality of the injured hand with extensive soſt tissue defects, motivate specialists to improve existing techniques.

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