Alwaleed Alammar, Jamal Almadani
Department of Plastic Surgery Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Clin Pract. 2020 Sep 7;10(3):1217. doi: 10.4081/cp.2020.1217. eCollection 2020 Sep 4.
A cold injury can result in devastating outcomes, leading to significant morbidity and loss of distal extremities. Amputations are common after severe frostbite injuries with delayed presentation, often mediated by post-injury arterial thrombosis. Ischemic injuries are managed according to the ischemia time. The most controversial aspect of treating a salvage injury is the time of surgical intervention, which used to be based on the previous management dogma . Recently, the paradigm has shifted to early surgical management if the level of viability of the deep structure can be ascertained using 99mTc pertechnetate scintigraphy (99mTc bone scans). We present a case of a finger amputation resulting from a cold injury secondary to a crush injury.
冷损伤可导致灾难性后果,引起严重的发病率和远端肢体丧失。严重冻伤且就诊延迟后截肢很常见,通常由伤后动脉血栓形成介导。缺血性损伤根据缺血时间进行处理。治疗挽救性损伤最具争议的方面是手术干预的时机,这过去是基于以往的管理教条。最近,如果可以使用高锝酸盐99mTc闪烁扫描(99mTc骨扫描)确定深部结构的存活水平,范式已转向早期手术管理。我们报告一例因挤压伤继发冷损伤导致手指截肢的病例。