Mofikoya Bolaji Oyawale, Ugburo Andrew Omotayo, Belie Orimisan
Burns, Plastic and Hand Rehabilitation Unit, Department of Surgery, College of Medicine, University of Lagos, Lagos, Nigeria.
Burns, Plastic and Hand Rehabilitation Unit, Department of Surgery, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria.
J Hand Microsurg. 2021 Jan 7;15(1):37-40. doi: 10.1055/s-0040-1722537. eCollection 2023 Feb.
Digit replantation is a complex surgery that nearly always needs to be done as an emergency. As such it is often difficult to teach. Several models have been developed to train surgeons in this procedure. We compare three rat models of replantation with the aim of ascertaining which most simulates the digit replantation. Inbred albino rats were selected and divided into three groups of 13 each, tail, penile, and hind replant groups. Three rats in each group were anesthetized, the specific amputation injury is created and is replanted for the anatomic component of the study. For the comparative section, 10 animals were anesthesized and the amputated parts were replanted under standard conditions. The parameters measured included weight, vessels and nerve diameters, method of fixation, total ischemia and replant times, the patency rates (after operation and at one week post surgery), as well as postoperative complications. All rats survived in the procedure. There was patency in all groups immediately. Rat tail group had 90%, penile group 100%, and hind limb group 90% survival 1 week after the replantation. There was one mortality in the hind limb group. The penile replant group was the shortest ( < 0.001), and all vessel sizes were comparable except the central artery of the tail which was significantly smaller ( < 0.001). The processes of the hind limb group most simulated the human digit replant procedure, though the ischemia and total replant times are significantly longer ( < 0.005). Though the immediate and 1 week patency rates were similar in all three groups, the hind limb replantation model involved steps most similar to human digit replant surgery and is recommended as the preferred teaching model.
手指再植是一项复杂的手术，几乎总是需要作为急诊进行。因此，它往往很难教授。已经开发了几种模型来培训外科医生进行这个手术。我们比较了三种大鼠再植模型，目的是确定哪种模型最能模拟手指再植。选择近交系白化大鼠并将其分为三组，每组13只，分别为尾巴、阴茎和后肢再植组。每组三只大鼠麻醉后，造成特定的截肢损伤，并为研究的解剖结构进行再植。对于比较部分，10只动物麻醉后，在标准条件下将截肢部分进行再植。测量的参数包括重量、血管和神经直径、固定方法、总缺血时间和再植时间、通畅率（术后和术后一周）以及术后并发症。所有大鼠在手术过程中均存活。所有组术后立即均通畅。再植后1周，大鼠尾巴组存活率为90%，阴茎组为100%，后肢组为90%。后肢组有一只死亡。阴茎再植组时间最短（<0.001），除尾巴中央动脉明显较小（<0.001）外，所有血管大小相当。后肢组的过程最能模拟人类手指再植手术，尽管缺血时间和总再植时间明显更长（<0.005）。尽管三组的即时和1周通畅率相似，但后肢再植模型涉及的步骤与人类手指再植手术最相似，建议作为首选的教学模型。
