Hand Replantation in 83 Year Old Man - Case Report

• Authors: Leszek Kaczmarzyk , Jerzy Jabłecki , Janusz Kaczmarzyk
• Languages of publication: EN

Abstracts

EN

Indications for hand replantation need to take into account the patients general condition and the severity of the trauma. The advanced age of the patient is generally considered as a limiting factor of the replantation but does not absolutely disqualify a patient.The case of a right - handed man, 83 years of age is presented, who had a circular- saw wrist level amputation of his dominant hand. As the general condition of the patient was satisfactory, the wound was clean, and the ischemia time was only 3 hrs the replantation of the hand was decided. The procedure was performed in a standardized way, the revascularization took place 7 hrs after injury. In the early post-operative period within the replanted part skin and soft tissue necrosis developed. It was treated with hyperbaric oxygen therapy, pediculed skin flap, and after its failure omental flap. The early functional result was poor (Chen's IV°). Patient died 27 weeks after replantation due to complications of coronaroplasty. The problems involved in replantation of hands of senile patients are discussed.

Keywords

EN

hand replantation; aged patients; operative risk

• Publisher: Index Copernicus International
• Journal: Polish Journal of Surgery
• Year: 2009
• Volume: 81
• Issue: 5
• Pages: 242-245

Dates

published

1 - 5 - 2009

online

8 - 9 - 2009

Contributors

author

Leszek Kaczmarzyk

• Subdepartment of Replantation of Limbs, General Surgery Department, St Hedwig of Silesia Hospital, Trzebnica

author

Jerzy Jabłecki

• Subdepartment of Replantation of Limbs, General Surgery Department, St Hedwig of Silesia Hospital, Trzebnica

author

Janusz Kaczmarzyk

• Subdepartment of Replantation of Limbs, General Surgery Department, St Hedwig of Silesia Hospital, Trzebnica

References

• Waikakul S, Vangdurongwan V, Unnanuntana A: Prognostic factors for maior limb reimplantation at both immediate and long-term follow-up. J Bone Joint Surg 1998; 80B: 1024-30.
• Jabłecki J, Kaczmarzyk J, Kaczmarzyk L i wsp.: Wyniki replantacji kończyn amputowanych w strefie 1/3 dalszej przedramienia. Pol Przegl Chir 2006; 78: 976-86.
• Livernaux P: Hand replantation in a 88 year old man: replanted senior? Chirurg Main 2002; 21: 355-58.
• Okuda T, Isihikura N, Tsudaka S: Digital replantation in the aged patent J Reconstr Microsurgery 1988; 4: 351-57.
• Meyer Z, Reckendorf G, Coulet B i wsp.: Replantation digitale après 60 ans: apropos de sept cases. Ann Chir Main 1999; 18: 153-59.
• Leong PC: Hand replantation in 83-year-old women - the oldest replantation. Plast Reconstr Surg 1979; 64: 416-18.[Crossref]
• Prowans P, Deskur Z, Brzeziński W i wsp.: Zaopatrywanie ubytków tkanek w obrębie kończyny górnej za pomocą sieci większej. Pol Przegl Chir 1998; 70: 54-59.
• Gaszyński W: Ocena ryzyka operacyjnego. W: Podstawy chirurgii, podręcznik dla lekarzy specjalizujących się w chirurgii ogólnej (red) J. Szmidt, Medycyna Praktyczna, wyd 1. Kraków 2003, s. 523.
• Brocklehurst JC, Allen SC: Zarys medycyny geriatrycznej. PZWL, Warszawa 1991.
• Gabl B, Kropel A: Evaluation of the subjective outcome following amputation of the upper limb using the DASH score. 7th International Symposium on Composite Tissue Allotransplantation, Seefeld, Sept. 7-8th 2007, Abstracts, p.47.
• Patradul A, Ngarmukos C, Parkpian V: Major limb replantation: a Tai experience. Ann Acad Med Singapore 1995; 24: 82-88.
• Feller AM, Graf P, Biemer E: Replantation surgery. Word J Surg 1991; 15: 477-85.

Identifiers

DOI

10.2478/v10035-009-0037-6