Repair of retrograde skin avulsion injury on the dorsum of the hand by replantation in situ with subdermal vascular network flaps

Objective To discuss the treatment outcome of replantation in situ with subdermal vascular network flap for repair of retrograde skin avulsion injury on the dorsum of the hand. Methods Fifty-six cases of subdermal vascular network flaps were performed from 1996 to 2001. The area of the avulsion skin was from 7 cm × 10 cm to 10 cm × 13 cm. Results All flaps survived uneventfully. Forty-six cases were followed up postoperatively for 3 months to 5 years. There was loss of follow-up in 10 cases. Satisfactory appearance was obtained in 46 cases, with restoration of the protective sensation and normal function of opposition of the thumb. According to TAM standard, the results of extension-flexion function from index to small fingers were excellent and good in 40 cases(87.0%). Conclusions Replantation in situ with subcutaneous vascular network flaps is one of effective procedures in management of retrograde skin avulsion injury on the dorsum of the hand when there was no or slight contusion on the skin.