Recomendaciones para optimizar el éxito en reimplante de dedos

Resumen

Los traumatismos con amputación o desvascularización de los dedos de la mano son lesiones complejas que precisan la derivación a unidades de referencia. El objetivo del reimplante es un resultado funcional y estético, y depende del traumatismo, del paciente y del cirujano. El éxito observado en reimplantes y revascularizaciones ha alcanzado el 89,5% en nuestra serie de 130 pacientes entre los años 2006 y 2019. La valoración inicial del paciente y de la parte amputada tienen repercusión directa en la indicación y el resultado final del reimplante. El desempeño de las técnicas de microcirugía es esencial para el éxito del procedimiento. En esta revisión, damos a conocer los diagnósticos prácticos así como la secuencia para la ejecución del reimplante desde antes de la llegada del paciente a quirófano, y proponemos una serie de detalles técnicos para ayudar al lector a conseguir el éxito de sus reimplantes.

Abstract

Injuries involving amputation or devascularization of the fingers are complex lesions which require that the patient is brought to a specialized and reference center. The ultimate goal of replantation is a good functional and cosmetic result, which will be conditioned by trauma-dependent factors, the patient and the surgeon. The success rate found in replantations and revascularizations is currently around 89,5% in our series of 130 patients between 2006 and 2019. An accurate initial assessment of the patient and the amputated part are critical and have a direct impact on the indication and the final outcome of the replantation. The performance in microsurgery techniques is essential for the success of the procedure. In this review we present practical diagnoses as well as the sequence of replantation, starting even before the patient reaches the operating room. We also suggest a series of technical tips to help the reader succeed in replantation surgery.

Palabras clave

reimplante - revascularización - microcirugía - dedo - amputación

Keywords

replant - finger - digit - microsurgery

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