Plastic Surgery
doi: 10.25005/2074-0581-2023-25-1-120-128
ANALYSIS OF COMPLICATIONS AFTER AUTOGRAFT TRANSPLANTATION IN SEVERE UPPER LIMB INJURY

G.D. Karim-Zade

Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: To analyze the complications after transplantation of vascularized autografts in upper limb injuries and develop a set of measures to eliminate them.

Methods: Surgical treatment outcomes of 159 patients with severe upper limb injury sequelae were analyzed. The study population comprised 102 (64.1%) males, 57 (35.8%) females, and 49.6% of the patients were under 18. In forearm and hand injuries sequelae, 159 vascularized skin fascia and skin-bone composite autograft flaps were used. Of the 159 grafts, free flaps grafting and pedicled flaps grafting were performed in 30 (18.8%) and 129 (81.2%), respectively.

Results: Of 30 free flaps, circulatory compromise was observed in 4 (13.3%) cases in the early postoperative period. Out of the total 159 grafts used, the percentage was 2.5%. In evaluating complications, it was revealed that the flap circulatory compromise of 4 patients was noted in the following grafting types: radial osseocutaneous (1), radial fasciocutaneous (1), fibula transplant (1), and inguinal fasciocutaneous (1). Of the 129 reverse and transposition flaps, a circulatory compromise was noted in 10 (7.7%) cases. Out of the total 159 flaps, the percentage of circulatory compromise was 6.3%. Of the total 159 free and pedicled flaps, necrosis with flap loss was observed in 6.9%.

Conclusion: Timely diagnosis of complications based on clinical and axillary investigations data facilitated conducting appropriate conservative measures or surgical revision, which helped to achieve engraftment of transplanted autografts in 93.1% of cases.

Keywords: Upper limb injury, injury sequelae, autotransplantation, flap engraftment, flap necrosis.

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Authors' information:

Karim-Zade Gulandom Dzhangovarovna,
Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University
Researcher ID: ABD-4810-2021
Scopus ID: 55908934800
ORCID ID: 0000-0003-0845-3197
E-mail: gulandom71@mail.ru

Information about support in the form of grants, equipment, medications

The author did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Karim-Zade Gulandom Dzhangovarovna
Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University

734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139

Tel.: +992 (918) 808766

E-mail: gulandom71@mail.ru

Materials on the topic:
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  2. REPAIR OF SEVERE POST-BURN CICATRICIAL CONTRACTURES AND DEFORMATIONS OF THE LOWER LIMB
  3. A MODEL FOR ASSESSING THE RISK OF A DELAYED WOUND HEALING IN OBESE PATIENTS
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  7. SURGICAL TREATMENT OF POST-BURN CICATRICIAL DEFORMITIES OF WOMAN’S BREAST

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