Pomeranian Medical University, Department of General and Hand Surgery.
Handchir Mikrochir Plast Chir. 2023 Feb;55(1):41-46. doi: 10.1055/a-1552-3684. Epub 2021 Oct 18.
Replantation of amputated hands is now considered a routine procedure in countries representing high standards of medical care. However, organization of care for patients with hand amputations is not uniform and varies from country to country, even in the European Union. This article presents organization of the Replantation Service for hand amputations in Poland, and ten-year activity report of the Service. Data to this report were obtained by mailing questionnaires to seven participating departments.A total of 974 patients, 871 men (89 %) and 103 women (11 %) at a mean age of 40 years with total or subtotal amputations or other severe upper limb-threatening injuries were admitted to the seven units participating in the Service. The most common injury was multidigital amputation - 353 (36 %), followed by the thumb - 282 (29 %), the metacarpal and wrist - 231 (24 %) and the forearm and arm - 108 (11 %) amputations. The most common operation was replantation of totally amputated hands/fingers - 368 cases (38 %), followed by revascularization of subtotal amputated hands/fingers - 344 (35 %). Primary reconstruction of a complex injury to the hand was performed in 135 patients (14 %). The rate of survival of the replanted/revascularized hands/fingers was a mean of 80 %. The report is supported by literature review about replantation services in other countries.
断肢再植现在被认为是高医疗标准国家的常规手术。然而，断肢患者的护理组织并不统一，甚至在欧盟国家之间也存在差异。本文介绍了波兰断肢再植服务的组织情况，并展示了该服务的十年活动报告。该报告的数据通过向七个参与部门邮寄问卷获得。共有 974 名患者，7 个参与单位收治了 871 名男性（89%）和 103 名女性（11%）患者，他们的年龄平均为 40 岁，患有完全性或不完全性断肢或其他严重上肢威胁性损伤。最常见的损伤是多指离断伤 - 353 例（36%），其次是拇指离断伤 - 282 例（29%），掌骨和腕部离断伤 - 231 例（24%）和前臂及手臂离断伤 - 108 例（11%）。最常见的手术是完全性断肢/手指再植 - 368 例（38%），其次是不完全性断肢/手指血运重建 - 344 例（35%）。135 例患者（14%）进行了手部复杂损伤的一期重建。再植/血运重建手/手指的存活率平均为 80%。该报告得到了其他国家再植服务文献综述的支持。
