Smearman Erica, Chan Patricia, Ghareeb Paul A
Emory University School of Medicine, Division of Plastic and Reconstructive Surgery, Atlanta, Ga.
Plast Reconstr Surg Glob Open. 2021 Dec 10;9(12):e4016. doi: 10.1097/GOX.0000000000004016. eCollection 2021 Dec.
Traumatic amputation injuries account for a substantial portion of emergency department visits. This includes digital amputations that may be considered for replantation. Following surgery, venous congestion is the most common cause of replant failure. To address this, several methods have been proposed to augment venous outflow. In this article, a simple and straightforward method that can be utilized to establish or augment venous outflow in cases of venous insufficiency is described. This method entails de-epithelization of the replanted digit pulp skin with use of postoperative anticoagulation. The area can be further expanded or stimulated to increase bleeding as needed and is allowed to heal by secondary intention. This method allows for reliable venous outflow with relative ease of implementation.
创伤性截肢损伤占急诊科就诊病例的很大一部分。这包括可能考虑进行再植的手指截肢。手术后，静脉淤血是再植失败的最常见原因。为了解决这个问题，已经提出了几种增加静脉流出的方法。在本文中，描述了一种简单直接的方法，可用于在静脉功能不全的情况下建立或增加静脉流出。该方法需要在术后抗凝的情况下对再植手指的指腹皮肤进行去上皮处理。该区域可根据需要进一步扩大或刺激以增加出血，并任其通过二期愈合。这种方法能够相对轻松地实现可靠的静脉流出。
