Il Modello HUB-SPOKE nella Gestione della Rete Trauma Mano Regionale: l’esperienza dell’Azienda Ospedaliera Universitaria Integrata di Verona

Hand trauma is defi ned as any open or closed injury distal to the elbow, considered complex when three or more tissues are involved. Effective trauma management is not only time-sensitive, but also requires rapid intervention and organization to ensure patient safety. The Integrated University Hospital (AOUI) of Verona aims to develop protocols and guidelines for emergency hand surgery.An organizational model has been implemented in line with national guidelines, pending a regional Hub-Spoke model. Two levels of intervention have been defined for hand surgery: “low” and “high” complexity, each with specific reference levels. Patients with traumatic injuries of the upper limb are directed along differentiated pathways based on the complexity of the injury and the competence of the facility.Patients with high-complexity injuries, after completing the diagnostic pathway and confirming general stability, are urgently referred to the HUB center following phone agreements with the on-duty surgeon. The AOUI of Verona serves as the regional HUB center for hand surgery, providing a 24-hour active service to manage complex traumas. The center must establish an effective organizational model to ensure safety and quality in the treatment of complex conditions of the upper limb.