Koshima Isao, Yoshida Shuhei, Imai Hirofumi, Sasaki Ayano, Nagamatsu Shogo, Yokota Kazunori, Mizuta Haruki, Harima Mitsunobu, Tashiro Jyunsuke, Yamashita Shuji
International Center for Lymphedema, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima City 734-8551, Japan.
International Center for Lymphedema, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima City 734-8551, Japan.
Hand Clin. 2019 May;35(2):179-184. doi: 10.1016/j.hcl.2018.12.007.
The authors describe 3 cases with successful fingertip replantations using supermicrosurgical arteriole (terminal branch of digital artery) anastomoses, arteriole graft obtained from the same fingertip defect, reverse arteriole flow to subdermal venule, and delayed venular drainage for venous congestion. Among these 16 consecutive distal phalangeal replantations, 7 fingers showed postoperative venous congestion (43.8% of the total fingers) and 5 were reoperated on with delayed venous drainage under digital block. All the reoperated fingers were successfully drained by additional single or double venous drainage with a vein graft (100% success rate). As a result, 13 fingers survived (81.3% success rate).
作者描述了3例成功进行指尖再植的病例，采用了超显微动脉吻合术（指动脉终末分支）、取自同一指尖缺损处的动脉移植、动脉逆向血流至皮下小静脉以及针对静脉淤血的延迟静脉引流。在这16例连续的末节指骨再植手术中，7根手指出现了术后静脉淤血（占总手指数的43.8%），其中5根手指在指神经阻滞下进行了延迟静脉引流的再次手术。所有再次手术的手指通过额外的单根或双根静脉移植进行静脉引流均获成功（成功率100%）。结果，13根手指存活（成功率81.3%）。
