Gittings Daniel J, Mendenhall Shaun D, Levin L Scott
University of Pennsylvania, 3737 Market Street, 6th Floor, Philadelphia, PA 19104, USA.
Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, 50 North Medical Drive, Salt Lake City, UT 84132, USA.
Hand Clin. 2019 May;35(2):103-108. doi: 10.1016/j.hcl.2018.12.001. Epub 2019 Feb 18.
Although upper extremity amputations have become less common in the workplace because of improvements in safety and equipment, the American health system's ability to provide emergent microvascular care for these injuries remains highly fragmented, inconsistent, overburdened, and at times unavailable. Over the past decade, hand surgeons have worked to improve this disparity within health systems. This article discusses the need for emergent microsurgical treatment, barriers encountered in improving access to care, and a description of current and future efforts of developing a sustainable network of highly specialized regional hand trauma centers.
尽管由于安全和设备的改进，上肢截肢在工作场所已变得不那么常见，但美国医疗系统为这些损伤提供紧急微血管护理的能力仍然高度分散、不一致、负担过重，有时甚至无法提供。在过去十年中，手外科医生一直在努力改善医疗系统内的这种差距。本文讨论了紧急显微外科治疗的必要性、改善就医机会时遇到的障碍，以及对建立可持续的高度专业化区域手部创伤中心网络的当前和未来努力的描述。
