Hand & Wrist Center of Houston Home If you suspect broken bones, dislocated joints, lacerated tendons, lacerated nerves, infection, or have an open wound below the elbow, then call us immediately.
 
WOUND RECONSTRUCTION


WHAT YOU SHOULD KNOW

Wound ReconstructionTraumatic wounds may be small or large, but what really matters is what lies underneath. If the wound exposes tendons, bones, joints, or nerves then it cannot be covered with a simple skin graft. It will require fully padded coverage with its own blood supply in the form of a flap. The word flap simply means a piece of tissue from the body that is used to reconstruct another area. Flaps may be local and stay connected by a piece of skin, regional and stay connected only by tiny blood vessels or free flaps that come completely separated and then rejoined by sewing together tiny blood vessels.

MEDICAL HISTORY

The details of the original injury circumstances are important to understand how much of the wound occurred due to cutting of tissue compared to crushing of tissue.

EXAMINATION

Measuring the dimensions of the wound and determining what other structures are injured in terms of fractures, dislocations, tendon and nerve lacerations.

ADDITIONAL TESTS

None are usually needed.

TREATMENT OPTIONS

 SKIN GRAFTREGIONAL FLAPFREE FLAP
CONSISTS OFSplit or full thickness section of skin placed over woundFull quality tissue coverage with its own attached blood supplyFull quality coverage with detachable blood supply
FEATURESTaken from outside of thigh if large or from nearby on hand if smallSources come from specific locations nearby according to a set of anatomic rulesWide choice of sources come from all over the body
ADVANTAGESSimplest methodNo sewing of blood vessels requiredMost versatile option, tailor to fit needs
DISADVANTAGESNo blood supply of its own, only works for wounds with no exposed structuresFlaps have size limitations and must reach to fit the woundSewing of blood vessels requires hospital stay and increases risk of complications

RECOVERY

After skin grafting or regional flaps, patients may be discharged from the hospital. Rehabilitation may be delayed a week or so to allow the tissue to stabilize before stressing with motion. Thereafter the rehabilitation is geared mostly to the other injuries sustained to the joints and tendons (refer to the relevant medical conditions pages). After free flap surgery, the patient remains in the hospital for 5 days of continuous anticoagulant medication by vein.
 
 
 
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  • I will miss everyone here, but I am pleased with my healing process and happy with my recovery. - 01/12/11
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  • Dr Henry did a wonderfull job and fixed the problems I had with no pain or worry. - 01/17/11
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