Revascularization at the Twelfth Hour Following a Rope-Induced Avulsion Injury: A Case Report

Abstract

ABSTRACT In amputation cases, success rates may generally depend on the surgeon's education and expertise, level of injury, mechanism of injury (knife injuries versus crushing and avulsion injuries), total versus subtotal amputation, age, gender, general health status, smoking status, ischemic time, patient selection and other factors. Clinical follow-up was performed on a patient who underwent revascularization as a result of subtotal amputation at the level of the IP joint of the left thumb due to an avulsion type injury with 12 hours of warm ischemia. The cause of injury in our 51-year-old male patient was a rope wrapped around his finger. The patient underwent radial sided digital artery repair and 1-month clinical follow-up was performed upon successful revascularization. Although there are relative contraindications such as type and duration of injury, the possibility of replantation should always be considered. It is possible to achieve successful and functional results even in our case with a warm ischemia period of 12 hours, an avulsion type injury and a damaged dominant artery depending on the severity of the avulsion.

Keywords

• Avulsion
• revascularization
• Ischemia time

İp ile Avulsiyon Yaralanması Sonrası Onikinci Saatte Revaskülarizasyon Olgusu

Öz

ÖZ Amputasyon vakalarında başarı oranları genel olarak cerrahın eğitim ve uzmanlığı ile yaralanma seviyesi, yaralanma mekanizması (bıçak kesisi, ezilme veya avulsiyon vb.), tam veya subtotal amputasyon, yaş, cinsiyet, genel sağlık durumu, sigara içme durumu, iskemik süre, hasta seçimi ve diğer faktörlere bağlı olabilir. Sıcak iskemi süresi 12 saat olan, avulsiyon tipte yaralanma nedeniyle sol el birinci parmak İP eklem seviyesinden subtotal amputasyon sonucunda revaskülerizasyon yapılan hastanın klinik izlemi yapıldı. Elli bir yaşındaki erkek hastamızın, yaralanma nedeni parmağına ip dolanması idi. Radyal taraflı dijital arter onarımı yapılan hastanın revaskülerizasyonu başarılı olması üzerine 1 ay klinik izlem yapıldı. Her ne kadar yaralanma tipi ve süresi gibi rölatif kontraendike durumlar olsa bile replantasyon ihtimali her zaman göz önüne alınmalıdır. Sıcak iskemi süresi 12 saat, avulsiyon tarzda yaralanması olan ve dominant arteri avulsiyon şiddetine bağlı olarak hasarlı olan vakamızda bile başarılı ve fonksiyonel sonuçlar elde etmek mümkündür.

Anahtar Kelimeler

• Avülsiyon
• Revaskülerizasyon
• İskemi zamanı

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