Engel J, Luboshitz S, Jaffe B, Rotstein Z
Department of Hand Surgery, Sheba Medical Center, Sackler School of Medicine, Tel Hashomer, Israel.
World J Surg. 1991 Jul-Aug;15(4):486-92. doi: 10.1007/BF01675645.
Many factors are involved in the decision whether to complete the amputation of an injured digit and trim the stump or to replant the amputated member. This paper compares the cost of these two treatments so that this financial aspect might be included among the many factors which influence the surgeon's decision. The cost of these treatments was separated into two aspects. First, the overall cost of the medical and surgical expenses was calculated. Second, the cost which the Israeli social security granted the injured worker due to the disability was calculated. By comparing the total surgical and medical costs of amputations and replantations, trimming is far less expensive than replantation. In the long run, the compensation the insurer owes the disabled trimmed patient is far higher than the compensation given to those who were successfully replanted, provided the injured worker has a certain number of working years to retirement and has a yearly income of a certain level. Thus, in most cases, replantation is recommended from the cost benefit aspect.
在决定是否对受伤手指进行截肢并修整残端，还是再植被截断的肢体时，涉及许多因素。本文比较了这两种治疗方法的成本，以便在影响外科医生决策的众多因素中纳入这一财务方面的考量。这些治疗的成本分为两个方面。首先，计算医疗和手术费用的总成本。其次，计算以色列社会保障机构因残疾给予受伤工人的费用。通过比较截肢和再植的手术和医疗总成本，修整残端的费用远低于再植。从长远来看，如果受伤工人距离退休还有一定的工作年限且年收入达到一定水平，保险公司欠残疾修整患者的赔偿金远高于给予成功再植患者的赔偿金。因此，在大多数情况下，从成本效益方面考虑，建议进行再植。
