Lee Z-Hye, Cohen Joshua M, Daar David, Anzai Lavinia, Hacquebord Jacques, Thanik Vishal
1 Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA.
2 Department of Orthopaedic Surgery, NYU Langone Health, New York, NY, USA.
J Hand Surg Eur Vol. 2019 May;44(4):414-418. doi: 10.1177/1753193418823595. Epub 2019 Jan 12.
We retrospectively reviewed 201 digit replantations or revascularizations that were performed between August 2007 and June 2015. Leeching therapy was used in 48 digits and was more commonly required in replanted digits. In revascularized digits, leeching was used significantly more frequently in avulsion injuries and injuries associated with fractures. Digits that were leeched for more than 4.5 days had significantly higher rates of survival of digits after replantation or revascularization. Leeching was associated with higher incidence of transfusion, higher mean number of transfusions, and longer length of stay. We conclude from this study that leeching is used more frequently after digital replantation than revascularizaion, and in revascularized digits, leeching is used more often in avulsion injury and in patients with fractures. In patients requiring leeching therapy, leaching for more than 4.5 days leads to higher rate of digital survival. Level of evidence: IV.
我们回顾性分析了2007年8月至2015年6月期间进行的201例断指再植或血管重建手术。48例断指采用了水蛭疗法，且该疗法在再植断指中更为常用。在血管重建的断指中，水蛭疗法在撕脱伤和合并骨折的损伤中使用频率明显更高。接受水蛭治疗超过4.5天的断指在再植或血管重建术后的存活几率显著更高。水蛭疗法与输血发生率更高、平均输血次数更多以及住院时间更长有关。我们从本研究得出结论，断指再植后水蛭疗法的使用频率高于血管重建，在血管重建的断指中，水蛭疗法在撕脱伤和骨折患者中使用更为频繁。在需要水蛭疗法的患者中，治疗超过4.5天可提高断指存活率。证据级别：IV级。
