Bueno Reuben A, Battiston Bruno, Ciclamini Davide, Titolo Paolo, Panero Bernardino, Tos Pierluigi
Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA.
Microsurgery Unit, Trauma Center, CTO Hospital, Via Zuretti 29, Torino 10100, Italy.
Clin Plast Surg. 2014 Jul;41(3):385-95. doi: 10.1016/j.cps.2014.03.010.
Techniques to improve the chance of successful replantation of digits are well established. Indications and contraindications for replantation are generally agreed on, but they continue to evolve as excellent outcomes are achieved at centers with experience and expertise. Form and function can be restored with avulsion injuries and distal amputations, with good results and high patient satisfaction. Increased financial pressure to control the costs of health care and increased accountability for evidence-based outcomes may lead to the regionalization of replantation care and shared decision making in recommending replantation or revision amputation.
提高手指再植成功率的技术已经十分成熟。再植的适应症和禁忌症已基本达成共识,但随着经验丰富且专业的医疗中心取得了出色的治疗效果,这些标准也在不断发展。撕脱伤和远端截肢可以恢复外形和功能,治疗效果良好,患者满意度较高。控制医疗成本带来的经济压力增加,以及对循证治疗结果问责的加强,可能会导致再植治疗的区域化,以及在推荐再植或截肢翻修时的共同决策。