PubMed · 14902933
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D S HAYWARD. 1952. Using the tools at hand.. https://doi.org/10.1097/00000446-195202000-00047
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The arterial system of fingers is anatomically well described, and so, usually no difficulties arise during its preparation and the making of anastomoses in replantation surgery. Difficulties may occur, however, during manipulation in the dorsal vascular bed of fingers, known only as a random venous network. There are minimal references to its existence and the location of its valvular apparatus. Using a microscopic preparation, a contrast staining, and a histological assessment, topographic relations and the course of veins of the dorsal venous network, as well as the existence and location of their valvular apparatus, was investigated on 72 three-phalanx fingers. The specimens were either harvested from fresh cadavers or traumatically amputated. We found that veins of rather significant caliber predominantly run along the dorsal aspect of the finger on both the radial and ulnar sides above the proximal phalanx of three-phalanx fingers. Proximally, venous systems of respective neighboring fingers connect in the interdigital space. The valvular apparatus was found at all levels ranging from metacarpophalangeal joints to the distal phalanx. The valves were always located distally from the confluence of two veins. Aside from this confluence, the existence of valves was not observed. The exact description of architecture of this venous system, in practice, contributes to faster orientation, better preparation, and the creation of safer anastomoses of these structures, and thus, to an increased success of replantation.
BACKGROUND AND OBJECTIVES: The goal of this study was to measure absorbed doses of radiation to the hands of medical staff performing sentinel node biopsy (SNB) in skin melanoma patients. METHODS: The study was conducted from January 2004 to May 2004, during SNBs (lymphoscintigraphy-(99m)Tc on albumin carrier, surgery after 24 hr; blue dye; intraoperative detection of gamma radiation) in 22 skin melanoma patients. During lymphoscintigraphy and surgical procedures, 57 highly sensitive thermoluminescent dosimeters (TLDs) were placed on different parts of the hands of the medical staff. RESULTS: Mean doses of radiation recorded on different parts of the hands of the physician injecting the radiotracer ranged from 2.43 to 84.11 microSv for single procedures, ranged from 3.20 to 5.84 microSv for the hands of surgeon, and ranged from 2.65 to 5.47 microSv for the hands of the remaining members of the medical staff. Absorbed doses of radiation to the hands of helping medical staff present in operating room was only slightly lower than absorbed doses to the hands of operating surgeon and assistant surgeon. CONCLUSION: The maximum recorded dose during this study was 1,900 times smaller than the current 1-year dose limit recommended by the International Commission on Radiological Protection (ICRP).
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