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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