断肢指再植
陈中伟:王存柏病例InJanuarysecond,1963,MachinecutJanuary,coldweatherAmputatedpartwrappedintowelReachhospitalwithin1hour
But,thistime…、、
WorldFirstHandReplantation
Doyoulikethislesson?DoyouwanttobeasurgeonasChenZhongwei?
LearningOutlineDefinitionandHistory定义和历史Classification分类Anatomy解剖Amputatedpartsstorageandtransportation断指得保存和早期处理Indications?适应症Surgicaltechniqueinsequence再植手术顺序Post-operativecare术后处理
DefinitionThesurgicalreattachmentofalimb/digit,thathasbeenpletelycutfromapersonsbody,restorethebloodcirculation,sothatlimb/digittogetthesurvivalandrecovery、将完全离断得四肢/手指重新接上,恢复其血液循环,使断肢/指得到存活和恢复功能得手术。
H?fner 1903 AnimalsurvivalJacobsonSuarez 1960 Smallvessel屠开元 1960 DogReplantationMalt 1962、5Arm陈中伟 1963、1 HandKomatsuTamai 1965 Fingers陈中伟 1966 FingersHistory
ClasscificationregularcutandRingAvulsionFingertipamputationAnatomyAftersurgeryGoodboneunionRingAvulsionAmputation脱套伤Aftersurgery
Classcification:oneormultiplefingersPre-OPLaterpost-OPPost-OP
Classcification:ForearmamputationPre-OPLaterpost-OP
大家有疑问的，可以询问和交流可以互相讨论下，但要小声点
Classcification:UpperarmamputationPre-OPPost-OPLaterpost-OP
AnatomyofDigitsThefingersaresuppliedbyvesselsandnerveswhichrunupthelateralaspectsofeachdigit、
HandAnatomyBecauseofjunctura(肌腱联合),apletetendonlacerationproximaltothejuncturamaystillresultinnormalextensorfunction、Theflexortendonsareenclosedinsynovialsheaths(滑液鞘)makingthemeasytodeepspaceinfections
Howtoacplishareplantation?
怎样完成断肢/指再植？
通过以下四个问题学习
QuestiononeAfteraccidence,whatshouldwedo?
StorageandtransportationStep1:?Puttheamputatedpartintoaplasticbag、Step2:?Putawater-tightknotatthetop、Step3:?Placetheplasticbagwiththefingerintoathermocolboxfilledwithice
DONOT-Putthepartandicecubestogetherinthesamebag、DON