PubMed HealthSearch

SEARCH · PubMed Health

Results for “Replantation”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources

Replantation of untidily amputated finger, hand, and arm: experience of 99 replantations in 66 cases.

Three problems the authors think important in replantation of untidy amputations are discussed based on our 99 replantations with the success rate of 92.6% over a 4-year period. To restore circulation in this type of amputation, such techniques as transfer of blood vessels, use of a neurovascular island flap with neurovascular anastomoses at its distal margin, vein graft, and free split-skin graft directly on the anastomosed blood vessels are recommended. Recovery of tendon gliding when replanted proximally to the MP joint was reasonably good but not when replanted distally to it. Recovery of intrinsic muscles was generally poor. Protective sensation was usually regained, although occasionally accompanied by paresthesia. Amputation of single digit was found not to be an absolute indication for replantation except for the thumb. In multiple digital amputation, more important digits should be restored by amputated digits in better condition. Replantation for cosmetic improvement may be justified in such cases as unmarried young females. In infants, replantation is especially worthwhile because good functional recovery and good further growth can be expected.

Adolescent

Replantation of digits and hands: analysis of surgical techniques and functional results in 71 patients with 86 replantations.

Defining replantation as the restoration of a completely amputated part as opposed to simply restoring circulation to an incompletely severed part, the results of replantation of 86 completely amputated parts in 71 patients performed from January, 1970, to December, 1975, were studied. Twenty-eight, or 32.5 percent, were the result of sharp severances of the part; localized crushing accounted for 56, or 65.1 percent. Two were classified as degloving injuries. Twelve amputations were transmetacarpal, six were at the metacarpophalangeal joints, 14 through the proximal phalanx, 15 at the proximal interphalangeal joint, 21 in the middle phalanx, 13 at the distal interphalangeal joint, and five through the distal phalanx. The technique consisted of bone shortening and fixation and repair of all tendons and nerves if possible. Veins are repaired first, at least two for each artery, and heparinized saline and lidocaine are used locally. Irrigation of the vessels is not done, but an intravenous bolus of 3,000 U. of heparin is given when the anastomoses are completed. Aspirin and low molecular weight dextran are given for 3 to 7 days. For the more distal replantation, heparin may be used. Antibiotics are given. In the total series of 86 completely amputated hand units, 52 were unsuccessful, primarly due to vascular thrombosis and usually on the venous side. In the year 1975 a success rate of 69.2 percent was achieved, whereas in the last 50 replantations, done between Jan. 1, 1976, and Oct. 15, 1976, the success rate was 90 percent. Results improved with more experience in the technique and with more careful selection of patients.

Adolescent

Digit replantation. Analysis of 163 replantations in an 11 year period.

From July 1965 to June 1976, 163 digits in 107 patients were replanted, and 145 digits survived-an 89 per cent success rate. Critical analyses were made of the causes of failures, complications, bone union, sensory recovery, secondary reconstructive procedures, and the final outcome. The majority of the patients were satisfied with their replanted digits, and no reamputation because of uselessness or causalgic pain of the replanted part has been necessary.

Adolescent

Hand replantation in an 83-year-old woman--the oldest replantation?

A replantation of the hand was performed in an 83-year-old woman. There was good survival and the early functional return was satisfactory. However, after a personal tragedy and after the physiotherapy slowed down there was rapid deterioration in her hand function. Disuse atrophy became so marked after two years that the replanted hand became a stiff organ with little function.

Age Factors

Replantation and revascularization of amputated parts of extremities: a three-year report from the Viennese replantation team.

A Replantation Team was instituted in Vienna 3 years ago. This team is the oldest in Europe. One hundred and eighty-one complete and incomplete amputated parts of 118 patients were replanted during this period. A survival rate of 86% and a useful functional result ("integrated parts") in 78% of the cases was obtained. Appropriate preparation of the amputated parts, the right timing, a 24 hour service and a clear indication with intensive postoperative physicotherapeutical treatment are the fundamental points for this result.

Amputation, Traumatic

Temperature monitoring in digital replantation.

Postoperative monitoring of replanted and revascularized digits with skin temperature probes was performed on the 20 patients admitted to the Duke University Medical Center Orthopaedic Replantation Service from April to July, 1977. Using multiple probes, temperatures were recorded for the replanted digit, a control digit on the same hand, and the dressing which represented the ambient temperature. In addition, the following simultaneous clinical inspections were performed on the digits: capillary refill, skin color, turgor, audibility of arterial Doppler tones, and amplitude of pulp pressure tracing. Temperatures of the replanted digits were in the range of 26.0 degrees to 35.0 degrees C. Control temperatures remained relatively stable, in the range of 33.0 degrees to 35.0 degrees C. From the authors' experience the patterns of temperature change which signaled changes in perfusion of the replanted digit and possible poor prognosis were (1) the temperature of the replanted digit dropping more than 2.5 degrees C while the control temperature stayed constant; (2) the temperature of the replanted digit dropping below 30.0 degrees C for longer than 1 hour; and (3) the control temperature dropping below 30.0 degrees C with no correctable cause found.

Adolescent

[Complications and failures through negative selection in replantation of amputated extremities].

Two years of experience with our replantation service in Vienna serves to define the criteria by which an amputated member is deemed worthy of replantation. 68 cases are analyzed and the complications and failures are discussed. The criteria took into account the type of injury, the ischemia time, the method adopted to preserve the severed part as well as the functional need of the amputee. We believe that by today's standard of replantation surgery, with the aid of microsurgical methods a responsible approach to indications would improve the functional results. Replantation capability, replantation possibility, replantation readiness and replantation obsession are all discussed.

Adolescent

Periodontal and pulpal healing of monkey incisors preserved in tissue culture before replantation.

The effect of delayed replantation and tissue culture as a prevention against root resorption was examined in green Vervet monkeys (Cercopithecus aethiops). Extracted incisors were kept in tissue culture medium (Eagle's medium) for 5--14 days before replantation. The extra-alveolar dry period before tissue culture ranged from to 0 to 60 min. Incisors not subjected to tissue culture served as controls. The animals were sacrificed 8 weeks after replantation. The following histologic parameters were registered for each tooth: surface resorption, inflammatory resorption, replacement resorption (ankylosis), downgrowth of pocket epithelium, and periapical inflammatory changes. The evaluation of the pulp included the extent, recorded in mm, of pulp survival. Histometric evaluation showed that teeth immediately placed in tissue culture medium for 5--14 days showed improved periodontal healing, exhibiting significantly less inflammatory resorption than control teeth immediately replanted. Also the extent of pulp survival was significantly increased in teeth replanted after tissue culture. Teeth bench-dried for 60 min and thereafter placed in tissue culture medium also showed a significant reduction in the amount of inflammatory resorption and increased amount of pulp survival compared with control teeth replanted after the 60-min dry extra-alveolar period. Replacement resorption (ankylosis) was found in all teeth in both groups.

Animals

Replantation of the upper extremity in children.

Since Malt and McKhann performed the first successful replantation of a traumatically amputated extremity in 1962, there has been a flurry of case reports and articles debating the pros and cons of the various technical aspects of replantation. There have been three case reports of children, under the age of 15, who have successfully undergone replantation of the upper extremity transected throught the humerus. The first case report in this article is the fourth. The factors involved in selecting replantation or amputation, and the technical aspects of the operation which are felt to be important, are briefly reviewed. Because the mechanics of limb replantation are rather straightforward, we feel that the pediatric surgeon should be familar with the preoperative and intraoperative factors to be weight, and that this alternative to stump closure be carefully considered when one is presented with an upper extremity transection.

Accidents, Occupational

Replantation of mature teeth without endodontics in monkeys.

The purpose of this study was to evaluate the histologic response after replantation of mature, developed teeth without endodontic treatment in monkeys. To serve as experimental controls, the other replanted teeth received endodontic treatment. No significant differences were noted in the rate and quality of periodontal tissues healing between the endodontically and the nonendodontically treated teeth in monkeys sacrificed at 5, 7, and 14 days, and at 1, 2, and 3 months after replantation. However, specimens obtained at 4, 6, 9, and 12 months showed that teeth replanted without endodontics developed periapical complications, whereas endodontically treated teeth did not.

Animals

Successful replantation of two avulsed scalps by microvascular anastomoses.

Two cases of immediate replantation of avulsed scalps by microvascular anastomosis are presented. This method of treatment seems to offer significant economic, social, and psychological advantages over split-skin grafting of the calvarium, or other presently used treatments. The need for secondary reconstructive procedures after a successful replantation is minimal, or nil. The mechanism of scalping is reviewed, and it is related anatomically to the structure of the galea aponeurotica. Specific recommendations are made regarding the immediate care of the avulsed scalp and the denuded calvarium, the value of a team approach in replantation, and various technical aspects of the procedure and postoperative management. The more frequent use of interpositional vein grafts is urged.

Adolescent

Successful replantation of an amputated leg in a child.

We report the successful replantation of an amputated leg in a 4-year-old boy. Four years after the replantation, skeletal growth and nerve regeneration were good and he had an excellent recovery of function and appearance. This result was undoubtedly enhanced by his youth, the ideal conditions for nerve repair, and the good preservation of the amputated leg in ice water. Replantation of an amputated lower extermity should be tried if the conditions mentioned above are fulfilled.

Amputation, Traumatic

A long-term review of digital replantation.

An analysis of the first 130 cases of digital revascularization and replantation performed at St Vincent's Hospital, Melbourne, during the period 1970-1977, confirms the long-term functional value of these procedures provided that strict indications for replantation are adhered to. Patient satisfaction has been almost universal, and objective testing shows that the most satisfying aspect of the procedure is the quality of sensory return. Flexor tendon function and the range of joint movement, however, are universally poor, and all patients complain of sensitivity to cold. The thumb has been by far the most satisfactory digit to replant, and avulsion injuries gave the poorest results, from the point of view of both survival and long-term function.

Adolescent

Evaluation of digital replantation--a review of 100 cases.

One hundred digital replantations and revascularizations of digits performed during a five year period were analyzed. Seventy replantations (70 per cent) survived and 62 were available for long term functional follow-up. Provided strict indications are observed, replantation is a most worthwhile procedure.

Adolescent

Two replantations of severed ear parts.

Two successful cases of replantation of part of an ear are presented; both were done by simple suture. The larger of these replants consisted of a 13 x 43 mm segment of the superior helix and concha. Both were vascularized beofre 48 hours. The greatest problem was venous congestion. In the larger replant we made multiple puncture wounds daily on both sides of the graft with an 18-gauge needle to help relieve this.

Adolescent

Digital replantation: a functional assessment.

With the advent of microvascular anastomosis it has become technically and practically feasible to replant amputated digits. In the last 5 years the achievements in this field of surgery have shown considerable improvement. Success is initially measured in terms of survival of the amputated digits but finally in terms of function. This paper presents a functional assessment of the authors' 33 digital replantations in 20 patients. In all of these patients the period of follow-up has been longer than 2 1/2 years. An 85% survival rate for the replanted digits was obtained. Of the 17 patients who have surviving digits function in 15 was judged to be significantly improved by the procedure. These results have permitted the development of guidelines for selecting patients who will benefit most from the procedure.

Adolescent