Effects of delayed abdominal skin flap on repairing whole hands' avulsion injuries

Objective To discuss the repair of whole hand's avulsion injuries with delayed abdominal skin flap. Methods There were a total of 11 patients with whole hand's avulsion injuries on both sides admitted to our hospital from June 2006 to March 2015.Of the 11 cases, 9 patients had machine crush and degloving injury, 2 cases with crush and thermal injury.After complete debridement in hands, the kirschner wire(1.2 mm) was used to fix the interphalangeal joints(PIP) into a straight position, then the hands were dragged to a relatively comfortable position of lateral abdominal wall and marked, and then they were buried by the abdominal flap, both the delayed abdominal skin flap and abdominal skin flap were applied to repair whole hand's avulsion injuries. Results It showed that all flaps in 11 cases survived postoperatively.The blood supply in flaps was normal with good abrasion resistance, and the hands function restored including grasp and pinch partly.Of the 11 cases, 1 case presented with tension blisters and the skin formed scabs partly, while it fell off after changing the dressing, 1 case had infection with kirschner wire exposed, and the infection was controlled by giving wound dressing and drainage with delayed debridement and suture.The patients were followed up for 6-12 months with satisfying abrasion resistance in flaps and hand function. Conclusion Repairing whole hand's avulsion injuries with delayed abdominal skin flap is effective.Hands function can restore partly including grasp and pinch, and patients can accomplish some fine motor tasks such as writing, which is an ideal method for repairing the whole hand's avulsion injuries on both sides.