{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T22:26:49Z","timestamp":1762900009300},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Reconstr Microsurg"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Machete injuries constitute a major cause of morbidity in Honduras. In this study, we aimed to determine the incidence, initial management, surgical treatment, and follow-up patterns for machete injuries at the national public hospital in Honduras. Microsurgery in Honduras is currently in transition with limitations at multiple levels. This study aims to provide critical information to better prepare visiting surgeons and establishes a blueprint to improve microsurgical reconstruction.<\/jats:p><jats:p>\n          Methods\u2003A retrospective chart review was performed to identify patients with machete injuries to the upper extremity (UE) who presented to the Hospital Escuela Universitario (HEU) for treatment from 2015 to 2017. Additional microsurgical data was obtained by personal communication with members of the plastic surgery department at the HEU.<\/jats:p><jats:p>\n          Results\u2003Complete data was retrieved for 100 patients who presented to the HEU with a UE machete wound. The cohort was male dominated (93%), employed as farmers (47%), and had a mean age of 32.1 years. Violence was the most common mechanism of injury (p\u2009&lt;\u20090.001). The majority of UE machete injuries involved tendon (70%), nerve (28%), and an open fracture (55%). Of the 76% of patients who were scheduled for a follow-up visit, only 25% attended. Within the last calendar year, one replantation, 10 revascularizations at the wrist and forearm level, three microvascular free tissue transfers, and 175 nerve repairs were performed.<\/jats:p><jats:p>\n          Conclusion\u2003Management of UE machete injuries in Honduras is challenging and requires early recognition of possible injuries to multiple anatomical systems. The majority of injuries required operative intervention. Only a small percentage of patients presented for follow up. A program to streamline care starting at injury recognition up to final follow-up is currently unavailable and needs to be developed to optimize microsurgical care.<\/jats:p>","DOI":"10.1055\/s-0040-1718366","type":"journal-article","created":{"date-parts":[[2020,10,8]],"date-time":"2020-10-08T23:01:20Z","timestamp":1602198080000},"page":"263-271","source":"Crossref","is-referenced-by-count":2,"title":["Beyond the Tip of the Blade: An Investigation of Upper Extremity Machete Injuries in Honduras"],"prefix":"10.1055","volume":"37","author":[{"given":"Anna Rose","family":"Johnson","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts"},{"name":"Division of Plastic and Reconstructive Surgery, Rutgers Robert Wood Johnson Medical School New Brunswick, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie S.","family":"La\u00ednez","sequence":"additional","affiliation":[{"name":"National Autonomous University of Honduras Faculty of Medical Sciences, Tegucigalpa, Francisco Moraz\u00e1n, Honduras"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herman J.","family":"Santos","sequence":"additional","affiliation":[{"name":"National Autonomous University of Honduras Faculty of Medical Sciences, Tegucigalpa, Francisco Moraz\u00e1n, Honduras"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Austin D.","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"La\u00ednez","sequence":"additional","affiliation":[{"name":"Section of Plastic Surgery, National Autonomous University of Honduras, Tegucigalpa, Francisco Moraz\u00e1n, Honduras"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel J.","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard L.","family":"Agag","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Rutgers Robert Wood Johnson Medical School New Brunswick, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard T.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Boston, 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An epidemiological study of an unusual injury","volume":"116","author":"K M Yip","year":"1997","journal-title":"Arch Orthop Trauma Surg"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"100","DOI":"10.5435\/00124635-199803000-00004","article-title":"Amputations of the fingers and hand: indications for replantation","volume":"6","author":"H J Boulas","year":"1998","journal-title":"J Am Acad Orthop Surg"},{"issue":"02","key":"ref15","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.cps.2006.11.003","article-title":"Replantation outcomes","volume":"34","author":"B D Medling","year":"2007","journal-title":"Clin Plast Surg"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1053\/jssh.2002.33319","article-title":"Replantation of the upper extremity: indications and outcomes","volume":"2","author":"K C Chung","year":"2002","journal-title":"J Am Soc Surg Hand"},{"issue":"02","key":"ref17","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1007\/s00268-010-0904-7","article-title":"Quantifying surgical and anesthetic availability at primary health facilities in Mongolia","volume":"35","author":"D A Spiegel","year":"2011","journal-title":"World J Surg"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1097\/AIA.0000000000000009","article-title":"The global anesthesia crisis and continuous quality improvement","volume":"52","author":"K AK McQueen","year":"2014","journal-title":"Int Anesthesiol Clin"},{"issue":"12","key":"ref19","doi-asserted-by":"crossref","first-page":"rjx243","DOI":"10.1093\/jscr\/rjx243","article-title":"Functional outcome after hand replantation in Guatemala","volume":"2017","author":"F Romero-Prieto","year":"2017","journal-title":"J Surg Case Rep"},{"issue":"04","key":"ref20","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1055\/s-0038-1626692","article-title":"Initial management of traumatic digit amputations: a retrospective study of functional outcomes","volume":"34","author":"L M Ngaage","year":"2018","journal-title":"J Reconstr Microsurg"},{"issue":"06","key":"ref21","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1055\/s-0037-1601052","article-title":"Long-term health-related quality of life outcomes in digital replantation versus revision amputation","volume":"33","author":"O Tessler","year":"2017","journal-title":"J Reconstr Microsurg"},{"issue":"03","key":"ref22","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1055\/s-0039-3400515","article-title":"Long-term quality of life after free flap upper extremity reconstruction for traumatic injuries","volume":"36","author":"S van Bekkum","year":"2020","journal-title":"J Reconstr Microsurg"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3109\/17453679509157155","article-title":"Major amputation of the upper extremity. 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