Soft Tissue Reconstruction of Upper Limb Injuries in Southwestern Nigeria: Methods and Outcome.

Abstract

Introduction: Upper limb injuries requiring soft tissue coverage are common in our environment. These reconstructions provide protection for vital structures and enable tendon gliding. Despite the frequency of these, there is a lack of data on the scope of soft tissue reconstruction and outcomes in our subregion.

Objectives: To demonstrate the scope and outcome of soft tissue reconstruction of upper limb injuries, we conducted a study at a major plastic surgery service in Southwestern Nigeria.

Materials and methods: This study employed a cross-sectional analytic approach, focusing on all patients with upper limb injuries requiring soft tissue reconstruction between April 2022 and March 2023.

Results: During the study period, a total of 49 patients underwent soft tissue reconstruction for upper limb injuries, with a mean age of 36.4 ± 11.3 years. The majority were male (n = 40, 81.6%). The methods of reconstruction included flaps (51%, n = 25) of cases, direct closure (36.7%, n = 18), and skin grafting (12.3%, n = 6). Among flap options, local flaps were utilized in 48% (n = 12), regional flaps in 32% (n = 8), and distant flaps in 20% (n = 5). The median time from injury to surgery, surgery to discharge, and length of hospital stay are 6 days, 6 days, and 13 days, respectively. Patients undergoing local flaps had a shorter injury-to-surgery time compared to those receiving regional and distant flaps (P = 0.026). Patients undergoing skin grafting, regional flaps, and distant flaps experienced longer hospital stays compared to those with direct closure and local flaps (P = 0.000). The in-patient complication rate was 14.3%.

Conclusions: The methods of soft tissue reconstruction for upper limb injuries in our institution include flaps, skin grafting, and direct closure.