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European Journal of Plastic Surgery

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17.11.2023 | Review

Soft tissue reconstruction of combat-related injuries in the upper limb—should serial debridement’s be prioritised over time to reconstruction? A systematic review and meta-analysis

verfasst von: Elena Whiteman, Hamza Ejaz, Umar Rehman, Manaf Khatib, Naveen Cavale

Erschienen in: European Journal of Plastic Surgery | Ausgabe 6/2023

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Abstract

Background

Major extremity trauma forms a considerable proportion of CRI. The aim of this study was to determine whether time to reconstruction and number of debridement’s had an impact on flap success in upper limb CRI.

Methods

A literature search was conducted on Pubmed, Dynamed, DARE, EMBASE, Cochrane, TRIP, Google scholar and BMJ databases. A random effects model was used due to significant heterogeneity between the papers and a meta-regression was implemented for the analysis of outcomes.

Results

Eight articles met the inclusion criteria, covering 65 patients and 74 flaps. Flap success rate was 93% (95% CI: 0.87 – 0.98) with an overall flap complication rate of 10.3% (95% CI 3.4% - 17.2%, p=0.02). Successful flaps had a mean of 8.3 (SD 4.76) pre-flap debridement’s versus 5.7 (SD 2.16) debridement’s in failed flaps.

Conclusions

Soft-tissue reconstruction in CRI often faces complexities due to associated injuries and the risk of infection. Whilst timely reconstruction is important, prioritizing meticulous and often multiple debridement’s over time targets may aid in flap success.

Level of evidence

Level III, Therapeutic.

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Titel: Soft tissue reconstruction of combat-related injuries in the upper limb—should serial debridement’s be prioritised over time to reconstruction? A systematic review and meta-analysis
verfasst von: Elena Whiteman
Hamza Ejaz
Umar Rehman
Manaf Khatib
Naveen Cavale
Publikationsdatum: 17.11.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Plastic Surgery / Ausgabe 6/2023
Print ISSN: 0930-343X
Elektronische ISSN: 1435-0130
DOI: https://doi.org/10.1007/s00238-023-02136-3

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Soft tissue reconstruction of combat-related injuries in the upper limb—should serial debridement’s be prioritised over time to reconstruction? A systematic review and meta-analysis

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Level of evidence

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