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Combined implantation of a serious hand injury repair


Anhui knuckle pressure, pay face bandaged. 3 days after injury underwent bilateral reconstruction of left second toe graft show, ring finger, will be outside the secluded front leg flap coverage of hand-transplant distal wounds. j rat dorsal lateral section = toes are moving House, too saphenous vein as a pedicle for the toe with the first and second dorsal metatarsal artery. Reserves the hot foot and the toe end of branch artery O. 5cm long, the left second toe to retain the two branches of the great saphenous vein for parallel anastomosis. Funeral 4 anterolateral left leg flap 12cm × 7CIII, the peroneal artery and vein as the pedicle, but also keep a branch of the peroneal artery pedicle. Reconstruction with toe transplantation the right first = left index finger, dorsal artery, saphenous vein and left, respectively, the radial artery nasal fossa marriage, the first Chi Chi jack table static amidine 'left ring finger and left second toe reconstruction, dorsal artery and recycling index finger of the toe of the foot to carry the text for the end anastomosis, saphenous vein static pull in end to end with the back of left leg to persuade Taiwan J anterolateral skin flap and reconstruction of the peroneal artery index finger of toe toe carried by the end of action blind end anastomosis, and reconstruction of the peroneal artery branches of the toe ring means carried by the foot deep to persuade Taiwan aortic end to end, the two large superficial peroneal vein and the vein down to kiss the two branches of end to end platform, the vertical axis in the flap rather to show, ring Zhiwei, respectively, to complete pinch, pinch, on the charge of movement, patient satisfaction row opponents Sheng shape. on one or vascularized tissue transplantation for hand injuries in the emergency repair planing surface, the rescue and preservation of hand function, and the reconstruction of hand function is Other surgical methods can not match. Due to technical progress,[link widoczny dla zalogowanych], the application portfolio migration approach means of vascular anastomosis into only one vascular pedicle tissue transplantation. Taiwan, under the group of transplanted tissue to participate in a number of other divided. A combination of migration, that is, two of the same or different organizations to participate in transplantation, two composite ports,[link widoczny dla zalogowanych], that three identical or different organizations to participate in transplantation. And so on. Second, the combination of graft donor sites involved in more technically demanding, long cooking time of surgery, once the serious consequences of failure, it must meet the following conditions to be implemented: (1) the designer and principal operator must have a rich clinical microsurgery experience, excellent microsurgical skills, have more success in tissue transplants from a single piece of inventory according to One! Man Man experience. (2) the patient function and appearance of the restoration opponents have a strong desire for a fix. On this basis, we have reason to hand injury under the circumstances, to choose the best transplanted tissue,[link widoczny dla zalogowanych], by way of combined transfer of functions to achieve the repair tissue and form the perfect goal. This group of units proposed indications for transplant surgery: (1) two or more different tissue defect, or different parts of the same defect, one defect can not be thrown by conventional therapy, (2) different parts of the organization defect, taken from a single flap, its size, shape, location Diego less than its repair requirements, (3),[link widoczny dla zalogowanych], each with two or more vascularized tissue transplantation, recipient can not provide multiple feeding arteries, to consider for Composite tissue transplantation Third, pay attention: the feeding artery should be selected by the District Department of Health kept organized opponents of the smaller arterial blood supply. Combined implantation of a clear progression in the transplanted tissue to determine vascular connections, the main vascular pedicle tissue transplantation as a combination of trunk, main trunk bifurcation parallel or serial peripheral secondary transplanted tissue. When combined transplantation of two, to try to shorten the recipient artery to the vascular pedicle between the length of the transplanted tissue, so that the entire vascular pedicle in the shortest possible distance. Combination of the choice of flap transplantation, in addition to the choice of following the general principles, but also should pay attention to flap transplantation in the mix position, including the vascular pedicle is long enough,[link widoczny dla zalogowanych], thick enough to artery diameter, and not for each subject area operations and so on. Fourth, the technical requirements of vessels then kiss, kiss each one connected in series or in parallel in the main vessel diameter should be equal, to ensure that blood flow to the transplanted tissue to kiss the hand sets are available for multi-vein than artery, should be used, for Each organization has its own independent transplant venous access, arterial and venous blood flow in order to balance.
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