Options for Covering Large Soft Tissue Defects After Trauma | Dr. Daniel Gould

Dr. Daniel Gould co-authored this review published in Current Trauma Reports, examining the surgical options available for reconstructing large soft tissue defects following traumatic injury. The review focuses on how surgeons can select an appropriate method of wound coverage while considering both functional and aesthetic outcomes.

Severe trauma can result in extensive loss of skin and soft tissue, sometimes leaving important structures such as bone, tendons, nerves, or blood vessels exposed. Successful reconstruction requires durable coverage that protects these structures while supporting wound healing and preserving as much function as possible.

The authors reviewed a range of reconstructive strategies, including skin grafting, local and regional flaps, free tissue transfer, perforator-based reconstruction, and artificial dermal substitutes. Each approach offers different advantages depending on the size, location, depth, and complexity of the injury.

The review also considers the tradeoffs associated with microsurgical free tissue transfer. While advances in microsurgery have expanded the ability to reconstruct complex wounds, harvesting tissue from another part of the body can introduce donor-site morbidity and additional surgical considerations.

Emerging technologies such as dermal regeneration templates provide another option for selected wounds. These materials may allow surgeons to cover larger defects while reducing the need to sacrifice healthy tissue elsewhere in the body.

The review emphasizes an individualized approach to traumatic reconstruction, selecting a technique that provides reliable wound coverage while minimizing morbidity and working toward the best possible functional and aesthetic outcome.