Versatility of Vein Grafts in Hand Neurovascular Reconstruction – Clinical Cases and Literature Review
Injuries to the upper limb may determine unexpected simple or complex soft tissue defects, due to different types of underlying injury mechanism, clean cut/stabs, crushing, torsion, avulsion or mixed types, which pose a challenge for the reconstructive surgeon. Ideally, all arterial, venous and nerv...
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| Format: | Article |
| Language: | English |
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Media Med Publicis
2021-12-01
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| Series: | Modern Medicine |
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| Online Access: | https://medicinamoderna.ro/wp-content/uploads/2021/12/Versatility-of-Vein-Grafts-in-Hand-Neurovascular-Reconstruction-%E2%80%93-Clinical-Cases-and-Literature-Review-14.pdf |
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| author | Alexandru STOIAN Florin-Vlad HODEA Roxana-Maria TOMEK ENESCU Andreea GROSU-BULARDA Mihaela Cristina ANDREI Flavia Francesca LITA Marius POPESCU Ioan LASCAR Razvan TEODOREANU |
| author_facet | Alexandru STOIAN Florin-Vlad HODEA Roxana-Maria TOMEK ENESCU Andreea GROSU-BULARDA Mihaela Cristina ANDREI Flavia Francesca LITA Marius POPESCU Ioan LASCAR Razvan TEODOREANU |
| author_sort | Alexandru STOIAN |
| collection | DOAJ |
| description | Injuries to the upper limb may determine unexpected simple or complex soft tissue defects, due to different types of underlying injury mechanism, clean cut/stabs, crushing, torsion, avulsion or mixed types, which pose a challenge for the reconstructive surgeon. Ideally, all arterial, venous and nervous lesions, in the distal upper limb should be repaired in an end-to-end technique, outside of injury zones, with healthy ends, in a tension free manner. However, situations arise where, either a tension-free repair is not possible, or a considerable defect is met, often representing a challenge to the surgeon. Therefore, a timely decision is imposed in order to find the most favorable approach to restore limb or segment perfusion, ensuring efficient venous return, as well as providing a sensate repair. Usage of vein grafts represents an essential tool comprised in the reconstructive surgeon’s armamentarium, with high versatility in nerve, arterial and venous reconstruction. Not only does it provide an ideal solution, with high adaptability to each case, but it also may enhance short- and long-term outcome, offering an optimal reconstructive option in any upper limb trauma situation, regardless of etiology. We aim to describe our therapeutic strategies in a series of challenging trauma cases involving digital structures from the upper limb. Interposed vein grafts were used to re-stablish sensate function in a patient with a collateral digital nerve defect, but also to bridge vital digit arterial defect in a torsion-avulsion thumb amputation, as well as re-establishing venous flow in patients with Urbaniak II finger degloving injury. |
| first_indexed | 2024-04-11T20:43:17Z |
| format | Article |
| id | doaj.art-35d11cac0ed84dd9b6a163f51bce8be4 |
| institution | Directory Open Access Journal |
| issn | 1223-0472 2360-2473 |
| language | English |
| last_indexed | 2024-04-11T20:43:17Z |
| publishDate | 2021-12-01 |
| publisher | Media Med Publicis |
| record_format | Article |
| series | Modern Medicine |
| spelling | doaj.art-35d11cac0ed84dd9b6a163f51bce8be42022-12-22T04:04:07ZengMedia Med PublicisModern Medicine1223-04722360-24732021-12-01284453459https://doi.org/10.31689/rmm.2021.28.4.453Versatility of Vein Grafts in Hand Neurovascular Reconstruction – Clinical Cases and Literature ReviewAlexandru STOIAN0https://orcid.org/0000-0003-0144-4634Florin-Vlad HODEA1Roxana-Maria TOMEK ENESCU2Andreea GROSU-BULARDA3Mihaela Cristina ANDREI4Flavia Francesca LITA5Marius POPESCU6Ioan LASCAR7Razvan TEODOREANU8Clinic of Plastic Surgery, Emergency Clinical Hospital, Bucharest, RomaniaClinic of Plastic Surgery, Emergency Clinical Hospital, Bucharest, RomaniaCalarasi County Hospital, RomaniaClinic of Plastic Surgery, Emergency Clinical Hospital, Bucharest, RomaniaClinic of Plastic Surgery, Emergency Clinical Hospital, Bucharest, RomaniaClinic of Plastic Surgery, Emergency Clinical Hospital, Bucharest, RomaniaClinic of Surgery, „Dr. Ion Cantacuzino” Clinical Hospital, Bucharest, Romania„Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania„Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaInjuries to the upper limb may determine unexpected simple or complex soft tissue defects, due to different types of underlying injury mechanism, clean cut/stabs, crushing, torsion, avulsion or mixed types, which pose a challenge for the reconstructive surgeon. Ideally, all arterial, venous and nervous lesions, in the distal upper limb should be repaired in an end-to-end technique, outside of injury zones, with healthy ends, in a tension free manner. However, situations arise where, either a tension-free repair is not possible, or a considerable defect is met, often representing a challenge to the surgeon. Therefore, a timely decision is imposed in order to find the most favorable approach to restore limb or segment perfusion, ensuring efficient venous return, as well as providing a sensate repair. Usage of vein grafts represents an essential tool comprised in the reconstructive surgeon’s armamentarium, with high versatility in nerve, arterial and venous reconstruction. Not only does it provide an ideal solution, with high adaptability to each case, but it also may enhance short- and long-term outcome, offering an optimal reconstructive option in any upper limb trauma situation, regardless of etiology. We aim to describe our therapeutic strategies in a series of challenging trauma cases involving digital structures from the upper limb. Interposed vein grafts were used to re-stablish sensate function in a patient with a collateral digital nerve defect, but also to bridge vital digit arterial defect in a torsion-avulsion thumb amputation, as well as re-establishing venous flow in patients with Urbaniak II finger degloving injury.https://medicinamoderna.ro/wp-content/uploads/2021/12/Versatility-of-Vein-Grafts-in-Hand-Neurovascular-Reconstruction-%E2%80%93-Clinical-Cases-and-Literature-Review-14.pdfvein graftupper limb traumamicrosurgeryneurovascular reconstructionring avulsion injuries |
| spellingShingle | Alexandru STOIAN Florin-Vlad HODEA Roxana-Maria TOMEK ENESCU Andreea GROSU-BULARDA Mihaela Cristina ANDREI Flavia Francesca LITA Marius POPESCU Ioan LASCAR Razvan TEODOREANU Versatility of Vein Grafts in Hand Neurovascular Reconstruction – Clinical Cases and Literature Review Modern Medicine vein graft upper limb trauma microsurgery neurovascular reconstruction ring avulsion injuries |
| title | Versatility of Vein Grafts in Hand Neurovascular Reconstruction – Clinical Cases and Literature Review |
| title_full | Versatility of Vein Grafts in Hand Neurovascular Reconstruction – Clinical Cases and Literature Review |
| title_fullStr | Versatility of Vein Grafts in Hand Neurovascular Reconstruction – Clinical Cases and Literature Review |
| title_full_unstemmed | Versatility of Vein Grafts in Hand Neurovascular Reconstruction – Clinical Cases and Literature Review |
| title_short | Versatility of Vein Grafts in Hand Neurovascular Reconstruction – Clinical Cases and Literature Review |
| title_sort | versatility of vein grafts in hand neurovascular reconstruction clinical cases and literature review |
| topic | vein graft upper limb trauma microsurgery neurovascular reconstruction ring avulsion injuries |
| url | https://medicinamoderna.ro/wp-content/uploads/2021/12/Versatility-of-Vein-Grafts-in-Hand-Neurovascular-Reconstruction-%E2%80%93-Clinical-Cases-and-Literature-Review-14.pdf |
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