Malheiro E, Amarante J, Reis J, Silva A, Conde A, Choupina M
Serviço de Cirurgia Plástica e Reconstrutiva, Hospital de S. João, Porto.
Acta Med Port. 1998 Mar;11(3):239-45.
Progress in micro or macro replantation has resulted in higher survival rates of formerly amputated parts. More amputated digits or limbs survive because the time of ischemia can be exceeded by using cold storage or perfusion. Homo or heterodigital vessel transposition, expanded indications for vein graft interposition, as well as heterotopic transplantation allow for extremity preservation even in crush injuries, and in disastrous multiple amputations combined with contusion or avulsion. Secondary reconstruction with regard to bone defects, tendon repair, and eventual nerve grafting have to be aspired, finally leading to an improvement of functional results in daily and leisure activities as well as in early professional readaptation. A total of 114 microvascular extremity replantations/revascularizations with a survival rate of 77.2% were followed for an average of 15 years.
显微或宏观再植技术的进步提高了以往被截断部位的存活率。更多被截断的手指或肢体得以存活，因为通过冷藏或灌注可以延长缺血时间。同种或异种手指血管移位、静脉移植适应证的扩大以及异位移植，即使在挤压伤、灾难性多处截肢合并挫伤或撕脱伤的情况下，也能实现肢体保全。必须致力于针对骨缺损、肌腱修复以及最终的神经移植进行二期重建，最终改善日常和休闲活动中的功能结果以及早期职业再适应情况。对114例微血管肢体再植/血管重建手术进行了随访，平均随访时间为15年，存活率为77.2%。
