Chen H C, Tang Y B
Department of Plastic Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan.
Hand Clin. 2001 Aug;17(3):433-45.
In replantation for avulsion amputation of the thumb, high survival rate of replanted digits depends on good debridement, good arterial repair with vein grafts or neurovascular bundles, and good coverage, with loose closure of the wound. The functional success depends on liberal use of nerve and tendon grafts or transfer; subsequent procedures, such as tenolysis and opponensplasty; and backup procedures for cases with severe soft tissue avulsion or long ischemic periods. All thumb amputations should be explored in the operating room for evaluation of replantability. If it is still questionable, an experienced microsurgeon should be consulted to choose between replantation and an alternative reconstructive procedure.
在拇指撕脱性断指再植中，再植指的高存活率取决于良好的清创、使用静脉移植或神经血管束进行良好的动脉修复，以及良好的覆盖，伤口宽松闭合。功能的成功取决于大量使用神经和肌腱移植或转移；后续手术，如肌腱松解术和对掌成形术；以及针对严重软组织撕脱或长时间缺血病例的备用手术。所有拇指离断伤均应在手术室进行探查，以评估再植的可行性。如果仍有疑问，应咨询经验丰富的显微外科医生，以在再植和其他重建手术之间做出选择。
