Muhammad Ahmad.
Management of hand trauma.
J Surg Pak Jan ;13(3):128-31.

Objective: To assess the outcome of the management of patients with hand trauma. Study Design: Descriptive study. Place and duration of study: This study was carried out from June 2005 to June 2008 in a private setup in Rawalpindi. Patients and Methods: All adult patients of hand trauma were included. Patients with acute/sub-acute/chronic wounds, those with postburn contractures or congenital deformities were excluded. Patients with associated closed fracture/dislocations, tendon injuries of hand were also excluded. The wounds were washed with antiseptic solution (povidine-iodine) and normal saline. Dressings were changed on daily basis. Other wounds were managed by skin grafting and flap coverage. Any complication occurring during the treatment was recorded. Results: One hundred fifteen patients were managed in a three year period. The mean age of male patients was 31.6 years and 30.8 years in females. Majority of male patients had road traffic accident (33.3%) followed by workplace accidents (22.2%). Most of the female patients had domestic accidents (17.5%) followed by road traffic accidents (12.7%). Majority of the patients underwent skin grafting (53.9%) followed by flap coverage (33.3%). Only 12.8% patients were managed conservatively. Cross-finger flap was carried out in 11.3% of the patients, 3.5% patients had groin flap and 2.6% thenar flap. Partial graft loss was seen in 4.35% of the patients. There was one case of complete graft loss and 2.61% patients had wound infection. Conclusions: Any wound on the hand should be evaluated and aggressively managed in order to reduce the morbidity and to improve the remaining function.

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