The History of Microsurgery

Tamai, Susumu

doi:10.1007/978-4-431-67865-6_1

Cited by 19 publications

(19 citation statements)

References 179 publications

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“…Improvements in microvascular techniques and instruments [10,18], patient preferences [13,15], technical abilities, surgeon preferences, and available evidence also affect decision-making [8,16], which remains quite variable.…”

Section: Introductionmentioning

confidence: 99%

Replantation and Revascularization vs. Amputation in Injured Digits

Mulders

Neuhaus

Becker

et al. 2013

Hand (New York, N,Y.)

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Background The purpose of this study was to analyze factors associated with the decision to replant or revascularize rather than amputate an injured digit as well as factors associated with successful replantation or revascularization. Methods We reviewed 315 complete and subtotal amputations at or proximal to the distal interphalangeal joint in 199 adult patients treated over 10 years. Ninety-three digits were replanted (30 %), 51 were revascularized (16 %), and 171 were amputated (54 %), including 5 attempted replantations. Bivariate and multivariable analyses sought factors associated with replantation vs. amputation, revascularization vs. amputation, and success of replantation or revascularization. Results Factors associated with replantation rather than amputation were injury to the left hand, thumb, middle digit, and ring digit, more than one digit affected, and surgeon. Factors associated with revascularization are surgeon and shorter ischemia time. Forty-five replantations (48 %) and 41 revascularizations (80 %) were successful. Successful replantation was associated with the side of injury (left side more likely to survive), zone of injury (distal interphalangeal and interphalangeal joint more likely to survive and proximal phalanx less likely to survive), and shorter ischemia time. Success of revascularization was associated with the mechanism of injury (saw and not crush injury), multiple digits involved, and the surgeon. Conclusions The decision to replant, revascularize, or amputate a nonviable digit and the success of replantation and revascularization are related to both injury factors, such as mechanism of injury, affected digit, and zone of injury, and the surgeon.

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Section: Introductionmentioning

confidence: 99%

Replantation and Revascularization vs. Amputation in Injured Digits

Mulders

Neuhaus

Becker

et al. 2013

Hand (New York, N,Y.)

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“…4 Advances have been made, drastically reducing free flap failures to less than 5 percent in most centers. [5][6][7][8] Perforator-based free tissue transfer decreases donor-site morbidity and offers versatile reconstructive options.…”

mentioning

confidence: 99%

Evidence to Support Controversy in Microsurgery

Fan

Patel

Mardini

et al. 2015

Plastic and Reconstructive Surgery

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Microsurgery practice, including preoperative patient selection, intraoperative technique, and anesthetic considerations, varies from institution to institution and from surgeon to surgeon. Many surgeons' practices are driven by "conventional wisdom," which is handed down from mentors to fellows and residents. In this article, the authors explore the oxymoron that there is evidence to support controversy in microsurgery. Indeed, if there was convincing evidence to support varying microsurgery practices, there would be no controversy. The authors conducted a review with a focus on evidence-based medicine to support microsurgery practice.

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“…(2003) described that prognosis of patients with extremity STS has not improved over the last 20 years, indicating that current therapy has reached the limits of efficacy. Development of reconstructive procedures, such as the newly developed free flaps and the pedicled or free musculocutaneous flaps in the 1970s (Tamai 2003), may not always have contributed to a marked reduction in the number of deaths from STS compared with that from non‐melanoma skin cancer, which was observed throughout 1979–1994 in Japan (Ohtsuka & Nagamatsu 2005). Therefore, early diagnosis, careful preoperative assessment and curative wide excision are essential in the management of patients with STS.…”

Section: Discussionmentioning

confidence: 99%

Changing trends in the number of deaths from soft tissue sarcoma in Japan, 1955-2002

Ohtsuka

Nagamatsu

2006

Eur J Cancer Care

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The incidence and number of deaths from soft tissue sarcoma (STS) have been reported to increase in many countries. However, those in Japan have not been analysed over a long span of time. The objective of this study was to analyse the changing trends in the number of deaths from STS in Japan. We analysed the annual trends in the number of deaths from STS from 1955 to 2002 in Japan using the data from the Vital Statistics of Japan, Statistics and Information Department, Minister's Secretariat, Ministry of Health, Labour and Welfare. Until 2000, the number of deaths from STS had increased. The recent value of the annual increased ratio of deaths from STS was 0.5%[95% confidence interval (CI): -1.2-2.2%]. Men continued to have a higher number of deaths than women. The general trends in age-standardized death rates were roughly upward before 1995, although the death rates tended to decrease thereafter. The number and proportion of deaths at or after 60 years of age were increasing. The peak age group of deaths was roughly the sixties before 1982, and the seventies after 1983. The individuals in their sixties and seventies should be the focus of health promotion activities.

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The History of Microsurgery

Cited by 19 publications

References 179 publications

Replantation and Revascularization vs. Amputation in Injured Digits

Replantation and Revascularization vs. Amputation in Injured Digits

Evidence to Support Controversy in Microsurgery

Changing trends in the number of deaths from soft tissue sarcoma in Japan, 1955-2002

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