[Post-traumatic stress syndrome in surgery of the hand].

During our collaboration with the Hand Surgery Unit (HCUG), we have managed trauma patients presenting lesions of the upper limb of varying degrees of severity. We were particularly interested in patients who had undergone amputations. We observed that late psychiatric interventions were generally poorly accepted by the patients and were of no use to these patients. In the light of these findings, we therefore elaborated a new strategy of intervention in collaboration with our surgeon colleagues. Patients with severe upper limb trauma were referred to us immediately after their admission. This approach presents three major advantages. Firstly, patients accept support more easily, knowing that they will be faced with psychologically difficult moments; secondly, we can help them to talk about their fears in relation to the future and thereby verbally express their anxieties and can therefore help them to face the future as effectively as possible; thirdly, we play a role in the communication between the surgical team, nursing team and the patient. We believe that this type of intervention improves the conditions of hospitalization and, in the long-term, should decrease the risks of a negative psychiatric outcome.