• Youn Hwan Kim, Siew-Weng Ng, Seung Ki Youn, Chang Yeon Kim, and Jeong Tae Kim.
• Department of Plastic and Reconstructive Surgery, School of Medicine, Hanyang University, 17 Haengdang-Dong, 133-792 Seongdong-Gu, Seoul, Republic of Korea.
• J Plast Reconstr Aesthet Surg. 2011 Jun 1; 64 (6): 827-30.

AbstractSevere crushing and degloving injury of the hand often involves multiple tissue structures requiring several stages of reconstructions. This is more challenging when tissue defect and loss of thumb co-exist, requiring vascularised tissue transfer and toe-to-thumb reconstruction in a hand that has severely compromised vascularity. The management variables to be considered include the use of pedicled or free flap, simultaneous or staged procedures, consideration for early rehabilitation and flap selection to facilitate simultaneous free tissue transfers without further jeopardy to the vascularity of the hand. We illustrate these considerations in a case we have managed with simultaneous application of a latissimus dorsi perforator flap and great toe-to-thumb transfer.Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

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