Soft Tissue Reconstruction of the Upper Extremity After Ballistic Injury.

Hand Clin · Aug 2025 · Review

Muetterties C, Miller AJ, Strohl A

Philadelphia Hand to Shoulder Center, Thomas Jefferson University Hospital, 834 Chestnut Street

Hand & Upper Extremity

SUMMARY — THE REDUCTIONOverview of upper-extremity soft tissue reconstruction after ballistic injury: staged debridement and stabilization, then coverage ranging from local flaps for low-energy wounds to free flaps for high-energy ones.
Abstract, as published

Ballistic injuries from projectiles such as bullets and shrapnel pose significant public health challenges, particularly in the upper extremities, leading to complex reconstructive needs. This article provides an overview of soft tissue reconstruction of ballistic injuries to the upper extremity. Management involves initial stabilization, staged debridement, and subsequent reconstruction depending on the defect which can range from simple debridement and local flaps for low energy projectiles and more extensive procedures for high energy projectiles, including negative pressure wound therapy, locoregional flaps, and possibly free flaps.

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