Plastic Surgery Reimplantation hand fingers

Replantation-Hand or Fingers

Objective

Replantation of amputated parts—hand or fingers—by micro­surgery.

Position

Supine with arm resting on a hand table.

Anesthesia

General + brachial.

Procedure

1.  Prepare amputated part and the stump and dissect its vessels, nerves, tendons and bone.

2.  Fixation of the amputated part with K wires.

3.  Repair tendons.

4.  Anastomosis of arteries, veins and nerves.

5.  Hemostasis.

6.  Closure dressing and splinting.

Instruments

•   Plastic surgery set

•   Microsurgery set

•   Hand surgery set consisting of:

     a.  Tourniquet (pneumatic)

     b.  Hand table

     c.  Rubber bands

     d.  K wires of different sizes

     e.  Wire driver with Jacob chuck and key

     f.   Fine periosteum elevation

     g.  Bone cutter

     h.  Wire cutting pliers

     i.   Esmarch’s bandage.

Sutures

•   Prolene 6 ‘0’ on curved round body needle (for tagging of vessels)

•   Prolene 4 ‘0’ on curved round body needle (for tendon repair)

•   Nylon 10 ‘0’ on 4 mm curved round body needle

•   Nylon 11 ‘0’ on 3.75 mm curved round body needle (for distal finger amputations)

•   Nylon 9 ‘0’ on 6 mm curved round body needle (for proximal and hand amputations)

•   Nylon 5 ‘0’ on curved cutting needle for skin

•   Dressing paraffin gauze

•   Gamjee pads

•   Velroc or Gypsona for splinting.

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