Importance of the Ribbon Sign, Indicating Unsuitability of the Vessel, in Replanting a Finger

Beek, Allen L. Van; UTZ, JOSEPH E. K.; Zook, Elvin G.; Castro, Cláudio Cardoso de

doi:10.1097/00006534-197801000-00007

Cited by 56 publications

(16 citation statements)

References 0 publications

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“…These streaks in avulsed skin are reported to be an indication of unsuitability in replanting the digits. 10 The avulsed skin in this patient was not ideal for replanting due to the extensive injury; however, replantation was attempted because of the lack of a better alternative. Despite good vascularity, with mild congestion in the palm and dorsum of the hand, the vascularity of the fingers beyond the middle phalangeal was inadequate.…”

Section: Discussionmentioning

confidence: 97%

Replantation of Total Degloving of the Hand: Case Report

Katsarma²,

Tm³

2003

J reconstr Microsurg

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This article reports a patient who had a total degloving of the hand, caused by a roller injury, up to the distal forearm level. The authors replanted the degloved skin using arteriovenous anastomosis of the radial artery at the wrist to the cephalic vein in the degloved skin in an end-to-side manner. To enhance the survival of the replanted skin, it was deepithelialized and buried in an abdominal pocket created specifically for this purpose. The replanted skin survived, except at the terminal portions of the fingers. The patient had reasonable function and cosmesis after the wound healed. The procedure may be used for the treatment of this rare injury to salvage a cosmetically acceptable and functional hand.

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Section: Discussionmentioning

confidence: 97%

Replantation of Total Degloving of the Hand: Case Report

Katsarma²,

Tm³

2003

J reconstr Microsurg

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“…4 Adventitial changes include a twisted vessel, stripped adventitia, "measles sign," and a speckled vessel. In addition, nerve fibers may exhibit various levels of damage, and stretched vessel walls appear in the form of a "ribbon sign," 18,19 described in the literature as tortuosity of the arteries at the injury site. When this finding is present, generous resection of the vascular "zone of contusion" in arterial repair can enhance overall replantation success rates in crush-avulsion injuries.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Extent of Vessel Avulsion Injury: An Experimental Study Using a Rabbit Model

Uraloğlu

Ural

Sayğın

et al. 2018

J reconstr Microsurg

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Background Determining the extent of damage in vascular avulsion type injuries still represents a challenge for the microsurgeon. Excision of the damaged section is critical for the success of anastomosis. The purpose of this study was to determine which among vascular endothelial and adventitia damage findings is most effective in determining the extent of avulsion injury. Methods Varying degrees of avulsion were applied to the aorta of 12 (n = 12) adult female New Zealand rabbits. Avulsion was first determined using adventitial findings and then with endothelial findings. The definitive extent of damage was determined histopathologically. Results The mean area of the histopathological sections was 16.7 ± 6.9 mm. The extent of damage measured from the adventitia was 15.8 ± 7.9 mm (the difference in histopathological examinations was not significant, p = 0.590, paired t-test), while the extent of damage from the lumen was 13.3 ± 8.2 mm (the difference in histopathological examinations was significant p = 0.004, paired t-test). Conclusion Excision based on adventitia findings is more effective in case of avulsion injury.

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“…1). In these cases, grafts cannot be used to reestablish the flow distally because of thrombogenic intimal injury up to the tip of the digit [19].…”

Section: Local Relative Contraindicationsmentioning

confidence: 99%

“…[25] The choice of reconstruction should aim to salvage a useful, functional limb, not just at limb survival alone [26]. [19]). …”

Section: Local Relative Contraindicationsmentioning

confidence: 99%