Clinical Practice Guidelines for Traumatic Vascular Injury of Hand in Srinagarind Hospital

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Chaiyos Vinitpairot
Nakarin Nimpisut
Settapon Wattanakamolchai
Tala Thammaroj
Surut Jianmongkol


Hands have sophisticated anatomy, and each anatomy has its own ubiquitous functions. Because of the nature of the upper extremity, it is susceptible to injury and ischemia. Hand injuries range from laceration wounds to amputation. Neglected injury to some structures of the hand often occurs. An open wound on hand does not mean only a skin problem; otherwise, the first doctor who evaluates the patient should recognize the vital organ that is capable of devastating injury. Misdiagnosis of the structure at hand leads to a poor outcome, despite the late reconstruction. To reduce neglected injuries, the authors reviewed the literature and developed clinical practice guidelines for evaluating open hand injuries during the pre-, intra-, and post-operative periods.


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Vinitpairot C, Nimpisut N, Wattanakamolchai S, Thammaroj T, Jianmongkol S. Clinical Practice Guidelines for Traumatic Vascular Injury of Hand in Srinagarind Hospital. SRIMEDJ [Internet]. 2022 Aug. 30 [cited 2023 Feb. 7];37(4):430-5. Available from:
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Tosti R, Eberlin KR. "Damage Control" Hand surgery: evaluation and emergency management of the mangled hand. Hand Clin 2018;34(1):17-26. doi:10.1016/j.hcl.2017.09.002

Weinzweig J, Weinzweig N. The "Tic-Tac-Toe" classification system for mutilating injuries of the hand. Plast Reconstr Surg 1997;100(5):1200-11. doi:10.1097/00006534-199710000-00020

Slauterbeck JR, Britton C, Moneim MS, Clevenger FW. Mangled extremity severity score: an accurate guide to treatment of the severely injured upper extremity. J Orthop Trauma 1994;8(4):282-5. doi:10.1097/00005131-199408000-00002

Campbell DA, Kay SP. The hand injury severity scoring system. J Hand Surg Br 1996;21(3):295-8. doi:10.1016/s0266-7681(05)80187-1

Shipp MM, Cho BH, Sanghavi KK, Daly CA, Giladi AM. The curtis hand injury matrix score: determining the need for specialized upper extremity care. J Hand Surg Am 2022;47(1):43-53.e4. doi:10.1016/j.jhsa.2021.07.034

Del Piñal F, Urrutia E, Klich M. Severe Crush injury to the forearm and hand: the role of microsurgery. Clin Plast Surg 2017;44(2):233-55. doi:10.1016/j.cps.2016.11.002

Prsic A, Friedrich JB. Postoperative management and rehabilitation of the replanted or revascularized digit. Hand Clin 2019;35(2):221-229. doi:10.1016/j.hcl.2019.01.003

Ketchum LD. Pharmacological alterations in the clotting mechanism: use in microvascular surgery. J Hand Surg Am 1978;3(5):407-15. doi:10.1016/s0363-5023(78)80133-6

Sun TB, Chien SH, Lee JT, Cheng LF, Hsu LP, Chen PR. Is dextran infusion as an antithrombotic agent necessary in microvascular reconstruction of the upper aerodigestive tract?. J Reconstr Microsurg 2003;19(7):463-6. doi:10.1055/s-2003-44634

Jayaprasad K, Mathew J, Thankappan K, Sharma M, Duraisamy S, Rajan S et al. Safety and efficacy of low molecular weight dextran (dextran 40) in head and neck free flap reconstruction. J Reconstr Microsurg 2013;29(7):443-8. doi:10.1055/s-0033-1343950

Veravuthipakorn L, Veravuthipakorn A. Microsurgical free flap and replantation without antithrombotic agents. J Med Assoc Thai 2004;87(6):665-9.

Matsusue T. Is Antithrombotic Therapy necessary following replantation of an amputated digit?. J Hand Surg Asian Pac Vol 2019;24(1):1-5. doi:10.1142/S2424835519500012

Zhu H, Zhu X, Zheng X. Antithrombotic Therapies in digit replantation with papaverine administration: A Prospective, Observational Study. Plast Reconstr Surg 2017;140(4):7436. doi:10.1097/PRS.0000000000003665

Kearns MC, Baker J, Myers S, Ghanem A. Towards standardization of training and practice of reconstructive microsurgery: an evidence-based recommendation for anastomosis thrombosis prophylaxis. Eur J Plast Surg 2018;41(4):379-86. doi:10.1007/s00238-018-1417-0

Dorf E, Blue C, Smith BP, Koman LA. Therapy after injury to the hand. J Am Acad Orthop Surg 2010;18(8):464-73. doi:10.5435/00124635-201008000-00003