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Page 6 of 8 Battiston et al. Plast Aesthet Res 2023;10:25 https://dx.doi.org/10.20517/2347-9264.2022.130

Table 1. AO Soft tissue classification
Closed skin lesions (IC)
IC 1 No evident skin lesion
IC 2 No skin laceration, but contusion
IC 3 Circumscribed degloving
IC 4 Extensive, closed degloving
IC 5 Necrosis from contusion
Open skin lesions (IO)
IO 1 Skin breakage from inside out
IO 2 Skin breakage from outside in < 5 cm, contused edges
IO 3 Skin breakage from the outside in > 5 cm, increased contusion, devitalized edges
IO 4 Considerable, full-thickness contusion, abrasion, extensive open degloving, skin loss
IO 5 Extensive degloving
Muscle and tendon lesions (MT)
MT 1 No muscle injury
MT 2 Circumscribed muscle injury, one compartment only
MT 3 Considerable muscle injury, two compartments
MT 4 Muscle defect, tendon laceration, extensive muscle contusion
MT 5 Compartment syndrome/crush syndrome with wide injury zone
Nerve and vessel lesions (NV)
NV 1 No neurovascular injury
NV 2 Isolated nerve injury
NV 3 Localized vascular injury
NV 4 Extensive segmental vascular injury
NV 5 Combined neurovascular injury, including subtotal or even total amputation

Table 2. “Tic-Tac-Toe” classification of anatomical zones [40]

ZONE 1 ZONE 2 ZONE 3
Proximal and distal phalanx of the Proximal, middle, and distal phalanx of the index and Proximal, middle, and distal phalanx of the ring and
thumb middle finger little finger
ZONE 4 ZONE 5 ZONE 6
First metacarpal bone Second and third metacarpals bones Fourth and fifth metacarpals bones
ZONE 7 ZONE 8 ZONE 9
Trapezium, trapezoid and Capitate and lunate Hamate, triquetrum and pisiform
scaphoid

joint), and a hand unit (from the metacarpophalangeal joint to the wrist) . Finally, the size is assessed in
[2]
relation to anatomic features rather than in centimeters: the defect is considered small if it affects only one
surface (dorsal, palmar, or lateral), medium if two surfaces are involved (two adjacent surfaces of the same
phalanx, or one surface of two adjacent phalanges at the fingers; two adjacent surfaces of a single metacarpal
or two adjacent metacarpals at hand), and large for any bigger or noncontiguous defects.

Similar to Ono’s classification is Das De’s , which analyzes the surface (dorsal and palmar) and the size
[42]
(number of "units" involved), like the previous one, but differs in location description: it classifies soft tissue
defects in radial, central and ulnar in order to indicate which local flap (when sufficient) is anatomically