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At least 145 records · Page 8Linked to original sources
PubMed2005

Several aspects of formation of auto-transplant and re-transplant vascular pedicle.

The purpose of the work was the simplification of technical side of autotransplantation and replantation by pre-preparation of vascular pedicle. 173 patients were observed and treated. Microsurgical autotransplantation of tissues was done in 29 cases, fingers autotransplantation in 44 cases (35 patients), fingers replantation in 66 cases (38 patients), replantation of thick parts of extremities in 34 cases (3 patients). Thoracodorsal flap on the neuro-vascular flap was transplntated in 16 cases, groin flap in 3 cases, deltoid flap -- in 3 cases, scapular flap -- in 1 case, saphenal -- 1 case, gracilis muscle in 3 cases, iliac crest flap in 2 cases, rib segment on vascular pedicle -- in 8 cases. Rib segment was transplanted as an isolated and with pre-prepared thoracodorsal bone-soft tissue complex also. II toe-finger and II-III toe-fingers block were transplanted for the abnormalities of the hand. Good and satisfactory functional and aesthetic results were obtained in all cases of autotransplantation and replantation. Original method of anastomosing of vessels was used in vein transplantation. We could simplify and increased the number of good results of operations by pre-preparing vascular pedicle. The results of treatment were improved by optimal election of donor site and preliminary forming of vascular pedicle of flaps and replants.

Anastomosis, Surgical↗
PubMed1993

Fractures and dislocations of fingers and toes. Principles, tips and pitfalls.

If each injury is carefully assessed on its merits good outcomes will be achieved. If any kind of unusual situation is met advice should be sought early rather than late. Balancing competing concepts, especially with regard to mobilisation and immobilisation of the injured part, makes treatment of digital injuries a challenge to our ingenuity.

Finger Injuries↗
PubMed1992

Continuous local intraarterial infusion after prolonged arterial stasis in the fingers and toes.

Seven patients with trauma to eight digits and one toe went untreated for arterial stasis, with subsequent development of posttraumatic changes in skin coloration. In two patients involving two digits, a daily dose of 2,000 ml containing 240,000 U urokinase, 80 micrograms prostaglandin E1, and 10,000 U heparin in lactated Ringer's solution was administered by intravenous infusion for 10 consecutive days; one of the two digits became necrotic. In all subsequent patients, a daily dose of 80 ml containing 240,000 U urokinase, 40 micrograms prostaglandin E1, 10,000 U (maximum) heparin, and low-molecular-weight dextran was administered by continuous local intraarterial infusion for 10 consecutive days. These seven extremities survived, even in the case of two digits and one toe with over 50 hr of arterial stasis. We believe that revascularization of extremities following prolonged periods of arterial stasis may be possible by means of continuous local intraarterial infusion of antithrombotic agents.

Aged↗
PubMed1993

Influence of sensor site location on pulse oximetry kinetics in children.

A pulse oximeter sensor is used to monitor changes in arterial hemoglobin oxygen saturation (SpO2) in anesthetized pediatric patients. The authors compared the kinetics of desaturation and resaturation measured by sensors placed over central (tongue, cheek) and peripheral (finger, toe) vascular beds in children with congenital heart disease. Desaturation time was defined as the time which elapsed between the onset of apnea and a 4% decrease in SpO2 from baseline. The desaturation times averaged 24 +/- 12 s, 56 +/- 34 s, and 58 +/- 28 s for the cheek, finger, and toe, respectively (n = 40; P < 0.0001 for cheek versus finger or toe). Resaturation time was defined as the interval between the resumption of ventilation and a 4% increase in SpO2 above the nadir. Resaturation times averaged 12 +/- 8 s for the cheek, 40 +/- 36 s for the finger, and 47 +/- 25 s for the toe (n = 40; P < 0.0001 for cheek versus finger or toe). A comparison of the kinetics at two central sensor sites, cheek and tongue, respectively, revealed no significant differences in desaturation times (20 +/- 10 s vs 21 +/- 9 s) or resaturation times (10 +/- 6 s vs 7 +/- 3 s) (n = 13). The authors conclude that both desaturation and resaturation are detected earlier by centrally placed sensors.

Biosensing Techniques↗
PubMed1994

Parenteral dipyrone versus diclofenac and placebo in patients with acute lumbago or sciatic pain: randomized observer-blind multicenter study.

Two hundred and sixty patients with lumbago or sciatic pain participated in a multicenter observer-blind randomized trial to compare the efficacy and tolerability of dipyrone 2.5 g, diclofenac 75 mg, and placebo administered as an intramuscular injection once daily for the duration of one to two days. The effectiveness of the test treatments in relieving sciatic pain was measured by a visual analog scale (VAS) before and 30 minutes, 1, 2, 3, 6 and 24 hours after each injection. In addition, the patient's general well-being was measured on a 5-point rating scale on day 0, 1 and 2. At the end of the trial, the patients evaluated the overall efficacy of the study drugs on a 5-point rating scale. Minimal finger-toe distance was measured every day of the trial. Pain intensity on VAS (primary endpoint) showed a significantly greater reduction with dipyrone than with diclofenac or placebo between 1 and 6 hours after application (p < 0.01) and at the end of the trial (after 48 hours). Improvement in general well-being and minimal finger-toe distance was greatest in the dipyrone group. 59% of the patients with dipyrone assessed the overall efficacy as "excellent" or "very good", compared with 30% with diclofenac, and 18% with placebo. Adverse reactions were reported in only 7 patients (3%), 4 (5%) in the dipyrone, 1 (1%) in the diclofenac, and 2 (2%) in the placebo group.

Adult↗
PubMed1985

Continuous plexus blockade for improved circulation in microvascular surgery.

Five patients are presented who were fitted with an axillary plexus catheter for postoperative sympathetic blockade: 1 finger replantation, 3 toe-finger transfers, and 1 finger-finger transfer. This catheter caused spasmolysis and an increase in the circulation and in the acral systolic blood pressure. Simultaneously an adequate analgesic effect was achieved through the administration of local anesthetic. The muscle relaxation helped immobilize the extremity. The improved circulation, the analgesic effect, and the suppression of muscular activity through continuous plexus anesthesia help healing in replanted or transferred digits.

Adolescent↗