查詢結果分析
相關文獻
- Intra-Graft Heparin Injection to Improve the Survival Rate of Composite Graft of the Fingertip
- 骨科顯微手術在急症外傷的運用與發展
- The Influence of Intra-Graft Heparin Injection on the Survival of Composite Grafts
- Digital Replantation Under Digital Block Anesthesia
- Overview of Extremity Replantation in Taiwan by the National Health Insurance Database from 1996 to 2000
- Digital Replantation without Venous Anastomosis
- 以耳後複合皮膚軟骨移植片修補鼻尖部之外傷缺損--二例報告
- New Era of Reconstructive Microsurgery
- The Early Microvascular Results and the Statistic Tool for Predicting the Finger Survival Rate of Finger Replantations and Revascularizations at Chang Gung Memorial Hospital
- Influence of Injury Level on Joint Motility after Finger Replantations
頁籤選單縮合
題 名 | Intra-Graft Heparin Injection to Improve the Survival Rate of Composite Graft of the Fingertip=移植片內肝素注射提升指尖複合移植片存活率 |
---|---|
作 者 | 侯政宏; 陳伊呈; 賴志昇; 呂俊德; 顏榮信; 宋定宇; | 書刊名 | 臺灣整形外科醫學會雜誌 |
卷 期 | 24:4 2015.12[民104.12] |
頁 次 | 頁327-337 |
分類號 | 416.615 |
關鍵詞 | 移植片內肝素注射; 斷指; 複合移植片; Composite graft; Fingertip amputation; Anticoagulation; |
語 文 | 英文(English) |
中文摘要 | 背景:處理指頭末端之斷指在臨床上有其困難度,處理的方式及成功率也有相當大的差異。當沒有適當的血管做吻合時,如何維持指頭長度、功能和外觀是本文所探討的重點。目的及目標:本文使用移植片內肝素注射來提高指尖復合移植片之存活率,並且建立術後處理流程。材料及方法:在2003年1月到2014年12月之間,總共有21個病人接受指尖復合移植片接合手術。所有的病人都有使用移植片內肝素注射。我們記錄了病患的年齡、受傷機轉、受傷程度、斷端大小以及移植片存活率。結果:在21位病人當中,總共有17位病人的移植片存活,存活率為80.9%。病人的平均年齡為27.9歲(介於1歲到61歲之間)。有10個手指頭(47.6%)是切割傷,另外11個手指頭是壓傷(52.4%)。平均存活的移植片長度為8.58mm.肝素平均的注射天數為9.43天。總共有四位病人接受輸血,平均的輸血單位為4.75單位。結論:在手指遠端的截指病人,要做顯微斷指接合並不是這麼容易。這時複合移植片可以提供一個維持指頭功能、長度以及外觀的選擇。移植片內肝素注射可以提升指尖複合移植片存活率。而我們所建立的指引可以幫助我們提高指頭末端接合手術的成功率。然而這樣的手術可能會需要輸血的治療以及延長住院天數,這些在術前都需與病人有效的溝通。 |
英文摘要 | Background: The management of very distal finger amputations is difficult and controversial, especially when the amputated part is preserved for replantation. In this study, we analyzed the outcomes of fingertip reattachment as a composite graft using intra-graft heparin injection and standardized the postoperative protocol. Materials and Methods: Between January 2003 and September 2014, we performed 21 composite graft fingertip reattachment for 21 patients. All patients received intra-graft heparin injection. The patients’ age, mechanism of damage, level of injury according to Ishikawa’s classification, amputation size, and overall graft survival rates were recorded. Results: Of 21 fingertip reattachments, 17 (80.9%) were successful. Five grafts (23.8%) achieved total survival and 12 grafts (57.1%) had partial survival. The average length of time needed for maintaining external bleeding by chemical leech was 9.43 days. The mean age of patients was 27.9 years (range, 1-61 years). Ten digits (47.6%) were injured by cutting and the other eleven digits (52.4%) by crushing. Ten digits (47.6%) were classified as Ishikawa level II and eleven digits (52.4%) were classified as Ishikawa level III. The average length of successful composite graft was 8.58 mm. Four patients received blood transfusion and the average amount of blood used was 4.75 units (range, 4-6 units). Conclusion: In traumatic fingertip amputation where microsurgical replantation may not be possible, a composite graft offers an option to restore finger function, length and esthetic appearance. Intra-graft heparin injection can improve the survival rate of composite graft of the fingertip. In this study we revealed a protocol that promotes controlled bleeding from the fingertip, which is essential to achieve consistently high success rates in fingertip reattachment. |
本系統中英文摘要資訊取自各篇刊載內容。