Tuesday, December 13, 2016

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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