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We report a case of a massive soft tissue injury in an Afghani soldier who suffered an IED injury. The primary goal of soft tissue reconstruction for highvelocity trauma should be primary closure of the wound with coverage of the bone and plates. Because of the temporary cavity trauma, extensive tissue undermining and flap rotation will almost always result in dead tissue. These principles were used to close this injury.
Needless to say, these extensive soft tissue injuries will need revision surgery after the initial wounds heal and the surrounding temporary cavity injury resolves