Postoperative Management and Rehabilitation of the Replanted or Revascularized Digit

Pršić, Adnan; Friedrich, Jeffrey B.

doi:10.1016/j.hcl.2019.01.003

Cited by 18 publications

(19 citation statements)

References 43 publications

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“…All venous occlusions were performed after the arterial ischemic episodes, which may have altered the ischemic tissue response. Nevertheless, we chose this sequence of ischemia since we assumed that venous occlusion would induce more edema and organ damage compared to arterial occlusion [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Microdialysis and CO2 sensors detect pancreatic ischemia in a porcine model

et al. 2022

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Background Pancreatic transplantation is associated with a high rate of early postoperative graft thrombosis. If a thrombosis is detected in time, a potentially graft-saving intervention can be initiated. Current postoperative monitoring lacks tools for early detection of ischemia. The aim of this study was to investigate if microdialysis and tissue pCO2 sensors detect pancreatic ischemia and whether intraparenchymal and organ surface measurements are comparable. Methods In 8 anaesthetized pigs, pairs of lactate monitoring microdialysis catheters and tissue pCO2 sensors were simultaneously inserted into the parenchyma and attached to the surface of the pancreas. Ischemia was induced by sequential arterial and venous occlusions of 45-minute duration, with two-hour reperfusion after each occlusion. Microdialysate was analyzed every 15 minutes. Tissue pCO2 was measured continuously. We investigated how surface and parenchymal measurements correlated and the capability of lactate and pCO2 to discriminate ischemic from non-ischemic periods. Results Ischemia was successfully induced by arterial occlusion in 8 animals and by venous occlusion in 5. During all ischemic episodes, lactate increased with a fold change of 3.2–9.5 (range) in the parenchyma and 1.7–7.6 on the surface. Tissue pCO2 increased with a fold change of 1.6–3.5 in the parenchyma and 1.3–3.0 on the surface. Systemic lactate and pCO2 remained unchanged. The area under curve (AUC) for lactate was 0.97 (95% confidence interval (CI) 0.93–1.00) for parenchymal and 0.90 (0.83–0.97) for surface (p<0.001 for both). For pCO2 the AUC was 0.93 (0.89–0.96) for parenchymal and 0.85 (0.81–0.90) for surface (p<0.001 for both). The median correlation coefficients between parenchyma and surface were 0.90 (interquartile range (IQR) 0.77–0.95) for lactate and 0.93 (0.89–0.97) for pCO2. Conclusions Local organ monitoring with microdialysis and tissue pCO2 sensors detect pancreatic ischemia with adequate correlation between surface and parenchymal measurements. Both techniques and locations seem feasible for further development of clinical pancreas monitoring.

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Section: Discussionmentioning

confidence: 99%

Microdialysis and CO2 sensors detect pancreatic ischemia in a porcine model

et al. 2022

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“…The postoperative x-ray included not only the fracture site and internal fixation [to verify fracture alignment and hardware placement], and the lung to make sure that no injury has occurred during surgery. When comfortable, the patient was discharged from the hospital and wound care continued until the removal of the sutures at the 2 nd week post-operative visit [9] .…”

Section: Postoperative Management and Rehabilitationmentioning

confidence: 99%

Clinical Outcomes of Plate Fixation Compared with Non-operative Treatment of Displaced Mid-shaft Clavicular Fractures in Adults

Sherif

Mohamed

Hassan

2021

International Journal of Medical Arts

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Background: Clavicle fractures are representing 2.6% of total body fractures. The common fracture is the midshaft fracture of the clavicle. The outcomes of non-operative treatment are not preferred nowadays, so the trend to surgical treatment of these fractures has grown. The aim of the work:The current study aimed to compare the outcomes of conservative and operative treatment of displaced midshaft clavicular fractures with plate fixation to clarify the merits and possible disadvantages of each method.Patients and Methods: Twenty patients as a convenient sample were included. These patients were subdivided into two groups, group I for conservative treatment and group II for operative treatment with plate fixation. All patients will be subjected to complete history taking, clinical, general &local examination, a standard anteroposterior view of the clavicle was done and follow up average 6 months.Results: At the end of follow up period, according to Constant Shoulder Score (CSS), 11 patients had excellent results (CSS: < 11), 4 patients had good results (CSS: 11-20), 3 patients had fair results (CSS: 21-30), 2 patients had poor results (CSS: >30). Pain VAS was significantly higher in group I compared with group II. There is a significant difference found between the groups as regard (outcome, pain VAS, the strength of abduction and the extent of internal rotation) P value < 0.05. There is no significant difference found between the groups as regard (socio-demographic data, comorbidities, fracture characteristics, fractures classification, degree of forward flexion, degree of lateral elevation and extent of lateral rotation) P value >0.05. Conclusion:Operative treatment with plate fixation is better than conservative treatment in management of pain, high union rate, good functional outcomes and greater patients satisfactory after displaced mid shaft clavicular fractures.

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“…The digit replantation aims to maximize the functional outcomes instead of the simple survival of the severed part. Indeed, the simple survival of the severed part involves a proper oxygenation and nutrient supply of the reattached part, while the functional outcomes depend upon the restoration of the anatomical characteristics such as bones, tendons, blood vessels, and nerves [1][2][3][4]. Anatomical considerations include the level of amputation and the degree of injury to the arterial intima and other soft tissue structures.…”

Section: Introductionmentioning

confidence: 99%

Knowledge, attitudes, and practice toward digit replantation among new nurses

Zhang

Tong

et al. 2023

Preprint

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Background Knowledge of the signs, symptoms, and management options of complications is essential for the nursing of patients after digit replantation and skin flap transplantation. This study aimed to explore the knowledge, attitudes, and practice (KAP) toward the postoperative nursing of patients with digit replantation and skin flap transplantation among new nurses.Methods This cross-sectional study was conducted at Beijing Jishuitan Hospital and Beijing No.6 Hospital between October 2022 and December 2022 among new nurses who had been in the profession for less than 2 years by a self-administered questionnaire.Results A total of 206 valid questionnaires were collected. The participants showed poor knowledge (7.72 ± 3.28, total scores: 13), moderate attitude (37.95 ± 6.05, total scores: 50), and active practice (38.23 ± 6.12, total scores: 45). The multivariable logistic regression showed good knowledge (OR = 2.55, 95%CI: 1.18–5.49, P = 0.017) was independently associated with favorable attitude. And favorable attitude (OR = 9.03, 95%CI: 3.88-21.00, P < 0.001) was independently associated with active practice.Conclusions The new nurses have poor knowledge, moderately attitudes, and appropriate practice toward severed digit replantation and skin flap transplantation. Proper training to improve knowledge of new nurse might be an optional method to improve their practice.

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Postoperative Management and Rehabilitation of the Replanted or Revascularized Digit

Cited by 18 publications

References 43 publications

Microdialysis and CO2 sensors detect pancreatic ischemia in a porcine model

Microdialysis and CO2 sensors detect pancreatic ischemia in a porcine model

Clinical Outcomes of Plate Fixation Compared with Non-operative Treatment of Displaced Mid-shaft Clavicular Fractures in Adults

Knowledge, attitudes, and practice toward digit replantation among new nurses

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