Johnson Shepard P, Drolet Brian C
Plastic and Reconstructive Surgery, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA.
Department of Plastic Surgery, Vanderbilt University Medical Center, 1211 Medical Center Drive, Medical Center North, D-4219, Nashville, TN 37232, USA; Department of Biomedical Informatics, Vanderbilt University Medical Center, 1211 Medical Center Drive, Medical Center North, D-4219, Nashville, TN 37232, USA; Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, 1211 Medical Center Drive, Medical Center North, D-4219, Nashville, TN 37232, USA.
Hand Clin. 2019 May;35(2):109-117. doi: 10.1016/j.hcl.2018.12.002. Epub 2019 Feb 23.
Replantation of a digit or hand is most successful when performed at a specialized, high-volume center. However, most patients with amputations initially present to local hospitals. Therefore, patients amenable to replantation frequently require expedited transfer to a tertiary center. To maximize success of digit replants, health care providers from both the referring and the referral hospital must be facile and expeditious at transferring the injured patient. The critical aspects of triage include assessment of the injury, patient communication, interfacility communication, preparation of the amputated part and patient, and a timely transfer.
当在专业的、大量开展此类手术的中心进行断指或断手再植时,成功率最高。然而,大多数截肢患者最初是在当地医院就诊。因此,适合进行再植的患者常常需要尽快转至三级中心。为了使断指再植成功率最大化,转诊医院和接收转诊的医院的医护人员在转运受伤患者时必须熟练且迅速。分诊的关键环节包括损伤评估、与患者沟通、机构间沟通、断肢及患者的准备,以及及时转运。