Soft Tissue Reconstruction of Complex Blast Injuries in Military and Civilian Settings: Guidelines and Principles

The increasing use of explosive devices in recent military operations has introduced complex patterns of injury requiring new reconstructive considerations. Proper initial management, staging, traditional and advanced reconstruction methods, and the use of regenerative medicine can have a drastic effect on outcomes. Even when limb salvage is not achieved, an understanding of residual limb length preservation and peripheral nerve techniques can improve functionality within the amputee patient. Surgery utilizing regenerative modalities and peripheral nerve techniques has shown promising results in military injuries with extensive soft tissue, orthopedic, and neurovascular damage. Improved understanding of the hybrid reconstructive ladder, the increased use of innovative surgical strategies, and further study into the benefits of regenerative medicine may lead to improvements in care for both military and nonmilitary trauma patients suffering from blast injuries.