Team Approach: Multidisciplinary Perioperative Care in Upper-Extremity Reconstruction for Adults with Spasticity and Contractures.

• Spasticity is the heightened motor tone that occurs as a result of damage to upper motor neurons in the central nervous system from brain or spinal cord injuries. * Nonoperative interventions for upper-extremity spasticity include chemodenervation or orthotic use, but their efficacy may be limited in correcting severe deformities. In such cases, surgical reconstruction may be necessary. * A single-event multilevel surgery (SEMLS) is a method of addressing deformities involving the entire extremity under 1 anesthetic episode. * It is the responsibility of the surgeon to assemble and communicate with the appropriate health-care team members during the patient's hospitalization to prevent perioperative complications and to optimize outcomes after surgery. Team entities integral to successful SEMLS for patients with spasticity include respiratory therapy, nutrition, neuropalliative care, internal medicine, occupational therapy, and anesthesiology. * The goal of upper-extremity reconstruction in patients with spasticity is to improve the patient's quality of life, reduce pain, improve hygiene, restore functionality, and correct disfiguring joint contractures.