CAN TEMPORARY ARTERY CATHETERIZATION EXTEND LIMITS OF ISCHEMIA TIME FOR MACROREPLANTATION?
ABSTRACT We observe delayed referrals to appropriate Microsurgery Unit and definitive treatment of traumatic limb amputations. Cases with wrist proximal amputations have a deadline for surgical replantation as these configure life-threatening injuries. Objective: To analyze patients with traumatic...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Ortopedia e Traumatologia
2023-12-01
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| Series: | Acta Ortopédica Brasileira |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-78522023000900208&lng=en&tlng=en |
| _version_ | 1827579716508319744 |
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| author | RAQUEL BERNARDELLI IAMAGUCHI GUILHERME MOREIRA DIAS FERNANDA DO CARMO IWASE MARCELO ROSA DE REZENDE RAMES MATTAR JR |
| author_facet | RAQUEL BERNARDELLI IAMAGUCHI GUILHERME MOREIRA DIAS FERNANDA DO CARMO IWASE MARCELO ROSA DE REZENDE RAMES MATTAR JR |
| author_sort | RAQUEL BERNARDELLI IAMAGUCHI |
| collection | DOAJ |
| description | ABSTRACT We observe delayed referrals to appropriate Microsurgery Unit and definitive treatment of traumatic limb amputations. Cases with wrist proximal amputations have a deadline for surgical replantation as these configure life-threatening injuries. Objective: To analyze patients with traumatic proximal wrist upper limb amputations with prolonged ischemic time who underwent temporary artery catheterization to assess stump viability and results. Methods: A case-series study including all patients with a proximal wrist upper limb amputation and a cold ischemic time equal to or above six hours from 2017 to 2021. Results: In total, two surgeons operated eight patients who had experienced forearm amputation injuries. Median ischemia time totaled eight hours. All patients required additional surgeries, most commonly split-thickness skin graft or fixation revision (three patients). This study obtained five successful macroreimplantations. The mean cold ischemia time was longer in the group with successful macroreimplantations (7.4 hours) than of the unsuccessful group (9 hours). Conclusion: Macroreplantations require immediate referral to microsurgery and, although temporary artery catheterization helps surgical decision making, the technique seems to fail to influence outcomes. Level of Evidence IV, Retrospective Case Series. |
| first_indexed | 2024-03-08T22:08:03Z |
| format | Article |
| id | doaj.art-00db4bd045794764bf6469f9a36b52a8 |
| institution | Directory Open Access Journal |
| issn | 1413-7852 |
| language | English |
| last_indexed | 2024-03-08T22:08:03Z |
| publishDate | 2023-12-01 |
| publisher | Sociedade Brasileira de Ortopedia e Traumatologia |
| record_format | Article |
| series | Acta Ortopédica Brasileira |
| spelling | doaj.art-00db4bd045794764bf6469f9a36b52a82023-12-19T07:48:23ZengSociedade Brasileira de Ortopedia e TraumatologiaActa Ortopédica Brasileira1413-78522023-12-0131610.1590/1413-785220233105e267476CAN TEMPORARY ARTERY CATHETERIZATION EXTEND LIMITS OF ISCHEMIA TIME FOR MACROREPLANTATION?RAQUEL BERNARDELLI IAMAGUCHIhttps://orcid.org/0000-0002-8965-5147GUILHERME MOREIRA DIAShttps://orcid.org/0000-0002-7732-4199FERNANDA DO CARMO IWASEhttps://orcid.org/0000-0001-9616-4381MARCELO ROSA DE REZENDEhttps://orcid.org/0000-0003-3441-8117RAMES MATTAR JRhttps://orcid.org/0000-0003-4202-4652ABSTRACT We observe delayed referrals to appropriate Microsurgery Unit and definitive treatment of traumatic limb amputations. Cases with wrist proximal amputations have a deadline for surgical replantation as these configure life-threatening injuries. Objective: To analyze patients with traumatic proximal wrist upper limb amputations with prolonged ischemic time who underwent temporary artery catheterization to assess stump viability and results. Methods: A case-series study including all patients with a proximal wrist upper limb amputation and a cold ischemic time equal to or above six hours from 2017 to 2021. Results: In total, two surgeons operated eight patients who had experienced forearm amputation injuries. Median ischemia time totaled eight hours. All patients required additional surgeries, most commonly split-thickness skin graft or fixation revision (three patients). This study obtained five successful macroreimplantations. The mean cold ischemia time was longer in the group with successful macroreimplantations (7.4 hours) than of the unsuccessful group (9 hours). Conclusion: Macroreplantations require immediate referral to microsurgery and, although temporary artery catheterization helps surgical decision making, the technique seems to fail to influence outcomes. Level of Evidence IV, Retrospective Case Series.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-78522023000900208&lng=en&tlng=enAmputationExtremitiesForearmMicrosurgeryCatheterizationWounds and Injury |
| spellingShingle | RAQUEL BERNARDELLI IAMAGUCHI GUILHERME MOREIRA DIAS FERNANDA DO CARMO IWASE MARCELO ROSA DE REZENDE RAMES MATTAR JR CAN TEMPORARY ARTERY CATHETERIZATION EXTEND LIMITS OF ISCHEMIA TIME FOR MACROREPLANTATION? Acta Ortopédica Brasileira Amputation Extremities Forearm Microsurgery Catheterization Wounds and Injury |
| title | CAN TEMPORARY ARTERY CATHETERIZATION EXTEND LIMITS OF ISCHEMIA TIME FOR MACROREPLANTATION? |
| title_full | CAN TEMPORARY ARTERY CATHETERIZATION EXTEND LIMITS OF ISCHEMIA TIME FOR MACROREPLANTATION? |
| title_fullStr | CAN TEMPORARY ARTERY CATHETERIZATION EXTEND LIMITS OF ISCHEMIA TIME FOR MACROREPLANTATION? |
| title_full_unstemmed | CAN TEMPORARY ARTERY CATHETERIZATION EXTEND LIMITS OF ISCHEMIA TIME FOR MACROREPLANTATION? |
| title_short | CAN TEMPORARY ARTERY CATHETERIZATION EXTEND LIMITS OF ISCHEMIA TIME FOR MACROREPLANTATION? |
| title_sort | can temporary artery catheterization extend limits of ischemia time for macroreplantation |
| topic | Amputation Extremities Forearm Microsurgery Catheterization Wounds and Injury |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-78522023000900208&lng=en&tlng=en |
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