断肢(指)再植-吕海.2.pptVIP

Definition History H?fner 1903 Animal survival Jacobson Suarez 1960 Small vessel 屠开元 1960 Dog Replantation Malt 1962.5 Arm 陈中伟 1963.1 Hand Komatsu Tamai 1965 Fingers 陈中伟 1966 Fingers Classcification regular cut and Ring Avulsion Classcification: one or multiple fingers Classcification: Forearm amputation Classcification: Upper arm amputation Question one Storage and transportation Question Two: Indications 适应证 Indications in detail Question Three: Surgical Technique in sequence Debridement 清创术 Shorten and Fix Bone (K wires?or?screws);? Repair the?Extensor Tendons 伸肌腱 ; Repair the?Flexor Tendons 屈肌腱 ; Anastomose 吻合 Arteries;? Anastomose Veins ; Repair Nerves； Close incision. Question Four: Future – Hand Allograft 异体手 Future-Bionic Hand 断指再植的适应证 全身情况良好 断肢/指条件，断肢/指部位、个数 再植时限：肢6-8小时，指12-24小时 年龄、性别 断指再植修复顺序 清创-骨-肌腱-血管-神经-闭合伤口 断指再植术后处理 抗感染 防血管危象 功能训练、防粘连 课后复习 运送断指时，正确的方法应该是什么？ 断肢（指）再植吻合血管时，其所吻合的动、静脉的适宜比例是？ 断肢（指）的急救及断肢（指）再植手术原则和顺序？ 断肢（指）再植术后什么时候较易发生血管危象? Post-op Care Clinical Color Capillary refill Temperature Bleeding Turgor 充盈 Doppler Surface Implantable Aftercare-Hand Rehabilitation The function of the replanted digit varies depending on the type of injury, the quality of the repair, and the post-operative healing course. Physical therapy after surgery is required to optimize function. Aftercare Infection Tendon adhesions Joint stiffness Malunion 骨畸形愈合 Cold induced vasospasm 血管痉挛 Complications Take home message * * * * * 断肢(指)再植 Replantation?of Amputated Limbs or Digits ? 南方医科大学第二临床医学院外科学教研室 Second Affiliated Clinical College of Southern Medical University 吕 海 History 陈中伟：王存柏病例 In January second,1963， Machine cut January, cold weather Amputated part wrapped in towel Reach hospital within 1 hour But, this time….. World First Hand Replantation Do you like this lesson? Do you want to be a surgeon as Chen Zhongwei? Learning Outline Definition and History 定义和历史 Classification 分类 Anatomy 解剖 Amputated