Order Now

Plastic Surgery Before A Hand Reimplantation

Category:

No matching category found.

0 / 5. 0

Words: 1857

Pages: 7

49

Plastic surgery before a hand reimplantation

The origins of reimplants of the upper member of the 60s, treated in the Brachial, Digital and Brachial region carried out in Shanghai, China, however, in 1964 the pioneers in the hand reimplant. Colombians Marcos Ramírez, who is a plastic surgeon, a pioneer in this procedure in Latin America, and Dr. Sabrina Gallego, who is also a plastic surgeon and also a specialist in surgery and hand microcirgery. Another magnetic case occurred in 1977, this case was carried out at the Zone Hospital in Mexico by the Drs. Felipe Flores Rodríguez and Humberto Rodríguez González, who after 41 years met again with their patient, who had carried out a normal life thanks to their successful recovery. 

They have also suffered various cases such as in Spain in 2018, where the doctor Pedro Cavadas could successfully perform a hand reimplantation to an American marina who had a trauma inside a submarine that amputated his right hand. However, Ecuador is not far behind around this area already in 2015, Dr. Lorena Escudero who is a reconstructive plastic surgeon was ableTraumatologist, anesthesiologist and prior to intervention the respective hematologist to avoid any non -planned circumstance. According to the testimony of (Escudero D., 2020) “Throughout my trajectory and experience operating in this branch of microcirurgery I have realized the most frequented cause of the amputation of the upper limb, in this case the hand, it is caused by a white weapon cut, although althoughHe also found various cases such as the member’s tear due to a certain grinding machinery that is usually used by masons.

Wait! Plastic Surgery Before A Hand Reimplantation paper is just an example!

Another cases have been due to the member’s tear as a result of a turtle bite. "Within the various steps that have to be taken into account within a hand reimplant, since, above all, the patient’s life is always above any other situation. 

Some factors that help determine if it is viable to proceed with the procedure are the age of the patient, the status of the amputated part, the type of amputated structure since in anatomical structures with greater musculature the procedure is difficult due to the need to perform a fasciotomy, systemic diseases stories such as diabetes or even hypertension, and something very important to rescue is the type and time of ischemia, understood by ischemia some cellular stress that we have had problems by the brake of the passage of blood flow, and thus the arterial capillaries andvenous cannot distribute oxygen, nutrients and waste substances respectively, to the different tissues. Another very important part to identify if you can proceed with surgery is whether the patient has the ability to follow instructions and indications directed by the doctor, in order to obtain a very successful rehabilitation program. 

On the other hand, in the event that the specialist decides notThe functional aesthetic amputation of the affected anatomical member. Thus, the patient, although it is true, would lose an anatomical part of his body, in this case the hand, which consists of 27 perfectly articulated bones, has no future problems due to any infection or damage to a vascular level since it has an anastomosisdirectly done in any case, the ideal would be to proceed with the operation as long as the procedure does not attempt against the patient’s life. At the time the plastic surgeon with his medical team decides to act in the face of the procedure to perform the corresponding hand reimplantation, the optimal conditions must be prepared. It is essential. 

Within the medical team responsible for preparing and performing the procedure, is the team for the amputated part, which must keep the segment in hypothermia. To be able to do that, we need to wrap the piece that is going to reimplant in a slightly moistened gauze with a saline solution to preserve it and after having done that, this equipment keeps the piece in a package that contains some water and ice,But the amputated segment is very important, I do not have prolonged contact with the water because if that is the case, what is called maceration could greatly soften the tissues. Likewise, the team that deals with the amputated part must take an radiography to identify the severity of the damage of the segment, and thus be able to define the level of the amputation. According to the doctor (Pachecho, 2008) “Whenever possible, the segment or amputated limb should be preserved in hypothermia in order to reduce cell metabolism and to prolong the survival of the member, while transferring the patient and the procedure begins, toThis is known as cold ischemia. ‘Another action that the team for the amputated part must take into account, is to avoid at all costs that the segment or member is in direct contact with the ice since they cause a cold burn which is also very frequent in the people whoThey climb snowless without proper protection and this type of burns damaging the tissue irreversibly. 

The team that prepares the patient is of the utmost importance, since it has the purpose of doing laboratory studies prior to surgical intervention, stories such as blood biometry and patient coagulation times, because according to the doctor (Escudero D. , 2020) have had cases in which the patient has had a systemic disease, but thanks to the proper pre -surgical studies, inconveniences have not been made to the patient’s life. The team that prepares the patient should not only perform the exams controlled above, but must request the anesthesiological evaluation. However, patient care must also realize psychologically, through a clinical psychologist, so that it can calm down a little before entering the procedure. In the event that there is a family time waiting for information about the state of the accident, the psychologist must also provide information to that person in order to reassure the situation. The next team that must act is the operating room equipment, since it is evident that without a place where to operate with optimal conditions, the intervention cannot be done. 

This equipment has the task of requesting the operating room available and also requesting the instrumentation that must be used, which in this case are the surgical microscope, suture instruments for the microanastomy of the blood capillaries that have been affected and also theWell -known tweezers, which is an instrument used for suture and forcision within the part of vascular surgery in this case within the instrumentation for the traumatologist, a turniquete device called Kidde must be requested. Among other materials that must be used, disinfected, are the scalpel, surgery scissors, bandage and plaster scissors. The containers and containers are very useful in the event that there is a foreign body that has been fixed, and discuss, in order to have the member with an asepsis that allows the procedure to be carried out without having complications with bacteria of any kind. Before reimplanting, it is important to clean the end of the amputated part and remove each of the strange materials, debrideing each part and with great skin care, because if it is not clear in an adequate way it can be necrosar and those tissues thatThey have been crushed, unfortunately they must be withdrawn, since this muscle is already devitalized. It is also essential to make incisions in a longitudinal, lateral way and dorsal flaps and fly. Thus, through lateral medium incisions you can better expose nerves and vessels for analysis. 

After the nerves and vessels have been identified, these must be separated by clips, enter through specific metal tools clips of a very small size modified in surgery of different kinds. According to (Mascaró, 2017) “The flaps on the island specified in the digital artery are flags specified in the dorsal red arterial metacarpia, and in the arterial arachniform arrangement of the subcutaneous region of the back of the hand, which corresponds to the defectsOf all the back of the hand and the dorsal region of the fingers, in addition to being very vascularized flaps, they have sensitivity through the digital nerve ”. With respect to the anatomical region that has been affected, in this case the hand, it is proposedgreater complications the veins, since it is well known that for each artery there are many times two veins . The amount of bone to be extracted through surgery, that is, to say, is variable, to be able to control an anastomosis of the blood vessels without voltage. 

In these situations, surgical intervention is carried out by using the structure structure repair technique, in order to perform the primary surgery of each of the structures, because in most cases some or some secondary surgeries are evidentAfter the hand reimplantation, this should be communicated to the patient to operate. An extensor tenure is performed, which is the suture of the ends of a sectioned tendon. In terms of anastomosis in the part of the arteries it is done when it is proven that there is an adequate blood flow through the light of the glass, which is the part inside the glass where the blood passes, but how is this done ?

It is done sweeping, that is, taking out blood clots towards the outside and thus permeabilizing the glass with a heparin solution so that the blood plasma can flow, thus there is a greater possibility of avoiding thrombosis, which is the formation of a clot of a clotBlood inside the vessel light. It should not. Wong, 2017) “When the terminal-terminal micro-surgical coaptation is not possible, nerve grafts are used, being able to control the sucural, or in case of availability and taking advantage of the region involved, use the nerve against medial cutaneous cutaneous. 

As for venous anastomosis, the attempt to anastomosar two veins for each artery is important for the same as for each arterial vessel the observation of two veins is very common. In the case of not being able to repair both venous vessels, according to (dr. Huang, 2017) It is very important to repair at least one vein. Within the osteosynthesis part, the plates allow an early mobilization and latermainly on the dorsal face of the same. As you do not have to leave the skin exposed, it must be closed with nylon, through any type of suture, but the important thing is that there is no tension. 

What should be given special attention is to protect the anastomosis that has been made of blood vessels. The completion of surgical intervention is not the last step to be able to say if it has been carried out successfully, since the reimplantation must be taken and this is of the utmost importance in order to raise the possibility of success in the reimplantation. One of the most frequent causes in terms of the difficulties after surgical intervention, is the risk of thrombosis, especially the venous that the arterial, although this occurs in most cases within the first three days of post -surgicalHowever, the risk is reduced after two weeks. In these cases to prevent the aforementioned, some type of anticoagulant is chosen in patients,  

Get quality help now

Top Writer

Arnold Foster

5.0 (218 reviews)

Recent reviews about this Writer

Thanks for the awesome essay! I’ve got an A-grade, and my teacher said it was the best paper in the class! I would definitely use your services again if I need help with my homework.

View profile

Related Essays

Epidemiology problem solving

Pages: 1

(550 words)

Road Education In Italy

Pages: 2

(575 words)

The Story of an Hour

Pages: 1

(275 words)

Women in the society revision

Pages: 1

(275 words)

People With Auditory Disabilities

Pages: 3

(705 words)

Health and Social Care Revised

Pages: 8

(2200 words)

Bad choices

Pages: 3

(825 words)