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Artiaco et al. Plast Aesthet Res 2023;10:57 Plastic and
DOI: 10.20517/2347-9264.2022.145
Aesthetic Research

Review Open Access

Treatment of infected soft tissue loss

Stefano Artiaco, Beatrice Limone, Daniele Vezza, Francesco Bosco , Fortunato Giustra, Giulia Colzani
Department of Orthopaedics and Traumatology, Orthopaedic and Trauma Center, Torino 10126, Italy.
Correspondence to: Dr. Stefano Artiaco, Department of Orthopaedics and Traumatology, Orthopaedic and Trauma Center, Via
Zuretti 29, Torino 10126, Italy. E-mail: sartiaco@cittadellasalute.to.it

How to cite this article: Artiaco S, Limone B, Vezza D, Bosco F, Giustra F, Colzani G. Treatment of infected soft tissue loss. Plast
Aesthet Res 2023;10:57. https://dx.doi.org/10.20517/2347-9264.2022.145

Received: 12 Dec 2022 First Decision: 29 May 2023 Revised: 15 Jun 2023 Accepted: 2 Sep 2023 Publishied: 13 Sep 2023

Academic Editors: Elias Polykandriotis, Pierluigi Tos Copy Editor: Dan Zhang Production Editor: Dan Zhang

Abstract
Hand coverage in infected soft tissue loss (STL) is a challenging clinical condition. Appropriate and well-timed
antibiotic therapy and careful debridement are crucial for the success of the subsequent reconstructive procedure.
Debridement must be radical, and all nonviable or infected tissue should be removed. Strict medical control and
multiple procedures can be required when infection recurrence is observed after primary procedure. Secondary
healing of STL is usually necessary in these complex conditions. Negative pressure wound therapy (NPWT) is often
used as a temporary instrument to reduce oedema and drainage, facilitating the attainment of a clean wound for
subsequent reconstruction. According to the type and size of the defect, multiple options ranging from skin grafts
and substitutes to local and free flaps can be selected for the treatment of infected STL. A reconstructive ladder
approach and case-by-case decision making should always be considered. Due to the unique function and role of
the hand, the surgical strategy must also take into account aesthetic and functional factors. Orthopedic and Plastic
surgeons should manage this wide variety of treatment options in a multidisciplinary and high-specialized context
including radiologists, microbiologists, infectious disease specialists and physiotherapists, customizing the
treatment path to the specific patient's situation.

Keywords: Reconstruction, flap, skin substitute, soft tissue loss, infection, hand, coverage

INTRODUCTION
STL in hand infections represents a clinical challenge for hand surgeons due to the complexity of the lesion
and the need for appropriate and multidisciplinary care. Understanding the principles of infection

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0
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