Vilain R
Nouv Presse Med. 1979;8(33):2683-5.
Injured hands may now be divided into two categories: those in which revascularisation by suture or bypass is necessary as an acute emergency and those in which classical reparative surgery suffices. As far as the first category is concerned, those who first see such patients should undertake the vascular repair but also all the others, if this is possible and desirable, or refer the injured individuals to a specialised centre. The prodigious development of microsurgery and its teaching to hand surgeons should soon make it possible for all injured patients to derive full benefit from this revolution. However, the indications must be perfectly defined in order to avoid the creation of handicapped patients and useless increase in surgical expenditure.
一类是作为急性紧急情况需要通过缝合或搭桥进行血管重建的；另一类是经典修复手术就足够的。就第一类而言，首先接诊此类患者的人员应进行血管修复，其他人员若有可能且合适，也应进行血管修复，或将受伤者转诊至专业中心。显微外科的巨大发展及其对手外科医生的教学，应很快使所有受伤患者都能从这场变革中充分受益。然而，必须明确界定手术指征，以避免造成残疾患者以及无端增加手术费用。
