Reconstruction of Post-Traumatic Soft Tissue Defects of the Hand and Fingers: Experience of the Department of Plastic and Burn Surgery a Series of 53 Cases

Abstract: The hands are essential organs, playing a crucial role in various functions such as sensation, motor skills (prehension), and communication. They are also a major symbol in our social interactions. Always visible, the hands contribute to the harmony of the body not only through their function but also through their form, size, and appearance. Injuries to the hand are common, especially in road traffic accidents (RTA). The management of these tissue losses is therefore crucial to restore not only the physical integrity of the hand but also the patient’s quality of life. Cutaneous substance loss of the hand, though variable in causes and location, remains a major challenge in reconstructive surgery. This work aims to describe the indications, advantages, disadvantages, and complications of the different methods of reconstruction of cutaneous substance loss of the hand and fingers, with a particular focus on local and locoregional flaps. This is a retrospective and descriptive study of 53 patients operated on for hand and finger substance loss in the Department of Plastic, Burn, and Hand Surgery of Avicenne Hospital, Rabat. Favorable outcomes were achieved in 80% of cases, both functionally (mobility and joint flexibility) and aesthetically (preservation of finger length and nail apparatus). Twenty percent of patients experienced complications such as flap suffering, necrosis, infection, stiffness, or sensory disturbance. To avoid amputation stump regularization, various reconstructive techniques have been proposed, ranging from secondary intention healing to microsurgical toe transfers using various types of flaps.