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再植或血管重建手指的术后管理与康复

Postoperative Management and Rehabilitation of the Replanted or Revascularized Digit.

作者信息

Prsic Adnan, Friedrich Jeffrey B

机构信息

Plastic and Reconstructive Surgery, Yale School of Medicine, PO Box 208041, New Haven, CT 06520-8041, USA.

Orthopaedics, Division of Plastic Surgery, University of Washington, Harborview Medical Center, Seattle Children's Hospital, 325 9th Avenue, Box 359796, Seattle, WA 98104, USA.

出版信息

Hand Clin. 2019 May;35(2):221-229. doi: 10.1016/j.hcl.2019.01.003. Epub 2019 Feb 18.

Abstract

Postoperative care of amputated digits begins before replantation. Detailed informed consent should be obtained and completion amputation discussed if revascularization is not ultimately successful. Complications and failure of the replanted digit should also be addressed. Postoperative pharmacologic treatment should consist of aspirin, at minimum. Complications, such as venous congestion or occlusion, and arterial thrombosis, should be dealt with expediently. Digital motion rehabilitation should start after 5 to 7 days of digital viability and splinting of the affected digit. Early protective motion protocol is implemented to maintain digital motion with emphasis on tendon glide and joint motion.

摘要

断指再植术后护理在再植手术前就应开始。应获得详细的知情同意书,并在最终血管再通不成功时讨论完成截肢的问题。还应说明再植手指的并发症和失败情况。术后药物治疗至少应包括阿司匹林。对于静脉淤血或阻塞以及动脉血栓形成等并发症,应及时处理。手指运动康复应在手指存活5至7天且患指进行夹板固定后开始。实施早期保护性运动方案以维持手指运动,重点是肌腱滑动和关节活动。

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