The comparative analysis of efficiency of the early and late reconstructive microsurgical operations at patients with extensive posttraumatic defects of upper extremities

Purpose: to conduct a comparative analysis of anatomic-functional treatment outcomes in patients with posttraumatic defects of upper extremity tissues according to the time of reconstructive microsurgical operations. Material and methods. The main study group included 190 patients, who have undergone early reconstructive-plastic operations using microsurgery techniques at R.R. Vreden Russian Research Institute of Traumatology and Orthopedics from 1990 through 2009. Late reconstructive-plastic operations on the upper extremity over the same period have been performed in 206 patients, who constituted the control group. In the main group, island flaps grafting was 3.6 times more frequent, than their free transplantation. Conversely, in the control group the latter type of surgery was 1.7 times more frequent. Outcomes. The main patient group demonstrated 82.9% excellent and favorable outcomes, whereas in the control group such outcomes were achieved only in 60.7% patients, the disability rate being three times higher in the control patients. Conclusion. Early use of operations of free axial tissue complexes transplantation and island flaps grafting allows for significant increase in excellent and favorable outcomes, decrease in the complication rate and unfavorable outcomes, which correspondingly reduces the disability rate.

дефект тканей верхней конечности, кровоснабжаемый комплекс тканей, микрохирургические реконструктивные операции, tissue defects, upper extremitiy, free flap, island flap, plastic reconstructive microsurgery