Zyluk Andrzej, Chrapusta Anna, Jabłecki Jerzy, Romanowski Leszek, Mazurek Tomasz
Pomorski Uniwersytet Medyczny w Szczecinie Klinika Chirurgii Ogólnej i Chirurgii Ręki.
Małopolskie Centrum Oparzeniowo-Plastyczne i Replantacji Kończyn z Ośrodkiem Terapii Hiperbarycznej w Krakowie z.
Pol Przegl Chir. 2018 May 22;90(4):1-5. doi: 10.5604/01.3001.0011.8176.
The paper summarizes 32 months (January 2014 - August 2016) of activity of the Replantation Service for hand amputation in Poland. Over this period a total of 568 cases of total and subtotal amputations as well as other complex injuries to the hand were referred. Of these, 354 referrals (62%) were accepted and 214 (38%) rejected. Among accepted, there were 167 total (47%) and 142 subtotal (40%) amputations; 45 patients (13%) had other severe hand injuries. Vast majority of the patients constituted males aged a mean of 39 years. The most common injury was amputation of several digits in one patient, and thumb amputation - a total of 229 cases (65%), followed by transmetacarpal and wrist amputations - 92 (30%) and forearm/arm amputations - 33 cases (9%). Replantation of amputated extremity was performed in 141 patients (40%), revascularization in 145 (41%) and in 29 (8%) primary repair of the complex injuries. In 27 cases (8%), a coverage of the tissue defects, and in 12 (3%) primary terminalization was performed. Survival rate was of 78% for replantation and revascularization. Comparing to the period 2010-2012, an increase in number of treated patients (of n=64 cases), in number of amputations (of 96 cases) and in number of amputated digits (of 88 cases) were noted. The activity report shows importance of Replantation Service, an informal structure, in saving limbs of severely mutilated patients.
本文总结了波兰手部再植服务在32个月（2014年1月至2016年8月）的活动情况。在此期间，共收到568例手部完全和不完全截肢以及其他复杂损伤的转诊病例。其中，354例转诊（62%）被接受，214例（38%）被拒绝。在被接受的病例中，有167例完全截肢（47%）和142例不完全截肢（40%）；45例患者（13%）有其他严重手部损伤。绝大多数患者为男性，平均年龄39岁。最常见的损伤是一名患者多个手指截肢，其次是拇指截肢——共229例（65%），然后是掌骨和腕部截肢——92例（30%）以及前臂/上臂截肢——33例（9%）。141例患者（40%）进行了断肢再植，145例（41%）进行了血管再通，29例（8%）进行了复杂损伤的一期修复。27例（8%）进行了组织缺损覆盖，12例（3%）进行了一期残端处理。再植和血管再通的存活率为78%。与2010 - 2012年期间相比，治疗患者数量增加了64例，截肢数量增加了96例，截肢手指数量增加了88例。活动报告显示了作为一个非正式机构的再植服务在挽救严重肢体残缺患者肢体方面的重要性。
