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[Management of hot press injury complicating with blood vessel injury in the upper extremity].

OBJECTIVE
To explore the therapeutic strategy of hot press injury complicating with blood vessel injury in the upper extremity.


METHODS
Decompression procedure was carried out in 8 patients with hot press injury complicating with blood vessel injury in the upper extremities, but the effect was not of satisfactory because there were injuries to brachial, radial and ulnar arteries and also injury to the superficial or deep palmar arch. The blood vessels were repaired with direct anastomosis, anastomosis with flexion of the limb, or transplantation with great saphenous vein, and the wounds were covered with intermediate split-thickness skin graft or pedicled thoraco-abdominal skin flap.


RESULTS
One patient with repair of the brachial artery and intermediate split thickness skin graft received amputation 4 weeks after operation because of lack of soft tissue coverage. The blood supply recovered completely in the other patients, so the affected limbs were saved.


CONCLUSION
Prompt exploration and repair of blood vessel, and coverage of the wound with healthy soft tissue are key procedures for the management of hot press injury complicating with blood vessel injury in the upper extremities.