Type of Surgery
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Last updated: 11/24/2009
The experienced surgeon can estimate the likelihood complications based on the nature of the injury. Replantations that are risky, such as those with circulatory perfusion problems, have lower success rates. Generally, the most difficult replantations...
are those that involve children under 10, injuries caused by a ring catching in machinery, and crush-and-tear injuries. Management of the difficult replant typically includes intravenous heparin to prevent clotting of the blood, and providing a continuous nerve block in either the median or ulnar nerve (depending on which fingers are reattached). A nerve block will cause vasodilatation, or expansion of the blood vessel. Vasodilatation will increase blood flow, bringing with it fresh oxygenated blood. Further evaluation should include checking the patient's dressing for constriction (i.e., if the dressing was placed too snugly and is constricting local blood vessels).
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This animation shows the function of the main skeletal muscles in the body. At the microscopic level, artists have animated how actin and myosin, (two muscle proteins) interact to make muscles contract.
To save a detached finger for reattachment surgery, it should be wrapped in a moist paper towel and put on ice (A). First the surgeon will reattach the blood vessels and nerves of the finger (B). The bone may be repaired with wires (C), and tendons are repaired (D). Skin and muscle wounds are also closed during the procedure. (Illustration by GGS Inc.)
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Finger reattachment (or replacement) is defined as reattachment of the part that has been completely amputated. Replantation refers to reattachment of a completely severed part, meaning there is no physical connection between the part that has been cut off and the person. Reattachment can be surgically performed for the finger and such other detached body parts, as the hand or arm.
From http://findarticles.com/p/articles/mi_gx5198/is_2004/ai_n19119766
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New procedures like minimally invasive procedures are often subject to scrutiny, but I think that one of the biggest problems facing these innovative procedures is for people to understand exactly what we do.
-Dr. Michael Perry, Laser Spine institute
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