Timing of management of severe injuries of the upper extremity by free flap-plasty

From October 1986 until December 1993, fifty-five patients with severe injuries to the upper extremity were treated with 59 free flaps. The mean follow-up period was 34 months (8 TO 87 months). The average hospital stay was 19 days (8 to 40 days). Depending on the timing of reconstruction, the patients were divided into three groups: emergency reconstruction (within 24 hours after injury), delayed reconstruction (up to seven days) and late reconstruction (after seven days). In this paper we present our regime of treatment of severe upper extremity injuries using a free flap and discuss the principles of free flap choice.