Department of Plastic Surgery, Case Western Reserve University, Cleveland, Ohio.
Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota.
Semin Plast Surg. 2013 Nov;27(4):182-9. doi: 10.1055/s-0033-1360585.
Surgical ingenuity has resulted in continuing microsurgical innovation in replantation. In this article, the authors define complex amputations as those that stretch the boundaries or fall outside traditionally defined indications for replantation. They discuss management of difficult situations involving multiple digit amputations, multiple-level amputations, prolonged ischemia, and multiple trauma. The role of transpositional and ectopic replantation, as well as the requirement for secondary procedures in replantation is also discussed. Although technically challenging, microsurgical management of complex amputations ultimately results in far superior outcomes.
手术的创造力导致了再植术的持续微创创新。在本文中，作者将复杂的断肢定义为那些超出传统再植适应证范围的断肢。他们讨论了处理多指断肢、多节段断肢、长时间缺血和多发创伤等困难情况的方法。还讨论了移位和异位再植的作用以及再植中需要进行二次手术的问题。尽管技术上具有挑战性，但复杂断肢的显微外科处理最终会产生更好的结果。
