大指畸形手术无止血带技术

IF 0.1 Q4 ORTHOPEDICS
T. O. Prasetyono, Timothy A. Santoso
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引用次数: 0

摘要

传统上,肢体手术中的止血带技术是为了产生不流血的手术区域。然而,止血带本身也有局限性;或者由于缺血效应可能发生的并发症,或者由于缺血时间而限制时间。由于没有外科医生预计他们的手术会出现可怕的不良事件,因此一种替代技术可能会满足需求。肾上腺素的使用以前被认为是危险的,现在已经在脚趾和手指等末端动脉器官中进行了。在这篇文章中,作者应用肿胀技术,使用1:1000000肾上腺素或简称为每密耳一次的溶液,而不使用气动止血带。该技术提供了相对清晰的操作领域,但安全。尽管由于血管口径增大和受影响手指周围的所有结构,出血的风险更高,但该技术有助于清晰显示重要结构。此外,每密耳一个肿胀溶液的长作用显著地提供了更长的手术持续时间,这有利于对大指进行复杂的手术。证据级别:证据处理级别四——案例系列。有关证据级别的完整描述,请参阅《作者须知》。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
No Tourniquet Technique of Surgery for Macrodactyly
The tourniquet technique in limb surgery has traditionally been performed to produce bloodless operative fields. Nevertheless, there are limitations derived from the tourniquet itself; either the complications that may occur because of the ischemic effects, or the constraint of time because of the ischemic time. As no surgeon expects dreadful adverse events in their practices, an alternative technique may fill up the demand. The implementation of epinephrine, which was previously believed to be dangerous, has been performed in end-artery organs such as toes and fingers. In this article, the authors apply the tumescent technique with the use of 1:1,000,000 epinephrine or shortly termed as one-per-mil solution, without using the pneumatic tourniquet. The technique presents relatively clear operative fields, yet safe. Although the risk of bleeding is higher because of the enlarged vascular caliber and all structures around the affected digits, the technique facilitates clear visualization of important structures. In addition, the long action of the one-per-mil tumescent solution notably provides a much longer surgery duration, which facilitates complex surgery for macrodactyly. Level of Evidence: Treatment level of evidence IV—case series. See Instructions for Authors for a complete description of levels of evidence.
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来源期刊
CiteScore
0.40
自引率
0.00%
发文量
18
期刊介绍: Techniques in Foot & Ankle Surgery offers a unique opportunity to master the most innovative and successful surgical techniques for correction of foot and ankle disorders. Featuring contributions from the world"s foremost orthopaedic surgeons and podiatrists, this quarterly journal supplies step-by-step details on these techniques. The contributors explain the rationale, indications, and contraindications for each procedure, identify the pitfalls and potential complications, and provide invaluable tips for improving results. The journal is illustrated cover to cover with intraoperative photographs and drawings, including several in full color.
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