Medicinal leeches and the microsurgeon: a four-year study, clinical series and risk benefit review.

Background: There are case reports and small series in the literature relating to the use of medicinal leeches by plastic surgeons; however, larger series from individual units are rare. The aim of this article is to present a comprehensive 4-year case series of the use of medicinal leeches, discuss the current evidence regarding indications, risks, and benefits and highlight the recent updates regarding leech speciation.

Methods: Patients prescribed leeches in a 4-year period (July 2004-2008) were collated from hospital pharmacy records (N = 35).

Component separation of the index finger to reconstruct the thumb: case report with review of literature.

Treatment options for severely damaged finger joints include amputation, arthroplasty, arthrodesis, and reconstruction using nonvascularized or vascularized joint transfers. The thumb contributes significantly to global hand function, and functioning metacarpophalangeal and interphalangeal joints are crucial. When 2 adjacent joints are damaged by trauma, vascularized joint transfer from an injured index finger to the thumb is an option to maximize remaining thumb function.

Microvascular Reconstruction of the Upper Extremity.

Background: Upper extremity composite tissue defects may result from trauma, tumor resection, infection, or congenital malformations. When reconstructing these defects the ultimate objectives are to provide adequate soft tissue protection of vital structures, and to provide optimal functional and esthetic outcomes. The development of clinical microsurgery has added a large number of treatment options to the trauma surgeon's armamentarium - primarily replantation of amputated tissues and transplantation of vascularized tissues from distant donor sites.