著者

服部 泰典 土井 一輝 川上 不二夫 日浦 泰博

出版者

一般社団法人 日本農村医学会

雑誌

日本農村医学会雑誌 (ISSN:04682513)

巻号頁・発行日

vol.46, no.1, pp.23-26, 1997-05-30 (Released:2011-08-11)

参考文献数

3

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指末節部の切断指再接着術後のうっ血に対し, 医療用に開発されたヒルを使用し良好な結果を得ることができた。わずか数十分の使用で数時間にわたる出血が得られ, 従来行われていた医師もしくは看護婦によるミルキング等の処置を必要とせず, 医療サイドの負担を大きく軽減させることが可能となった。ヒルの使用による感染の危険もあるが, 第2, 3世代のセフェム系抗生剤に感受性があるため十分予防可能である。

著者

林 洸太 服部 泰典 土井 一輝 坂本 相哲

出版者

日本マイクロサージャリー学会

雑誌

日本マイクロサージャリー学会会誌 (ISSN:09164936)

巻号頁・発行日

vol.31, no.2, pp.62-67, 2018 (Released:2018-06-25)

参考文献数

9

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In fingertip amputations, surgeons may encounter technical difficulties in vein grafting for anastomosis of small and fragile vessels.In this retrospective study, we evaluated the survival rate, complications, and surgical techniques for fingertip replantation with vein grafting.One hundred and twenty-five fingertip replantation procedures were performed in 116 patients between 1996 and 2017 at our hospital. There were 74 amputations in zone I and 51 in zone II. Twenty-five amputated fingertips in zone I were replanted with vein grafting for arterial or venous repairs. Among the 25 procedures with vein grafts, there were 11 with arterial repairs, 6 with venous repairs, and 8 with both arterial and venous repairs.In the procedures with vein grafting, vascular thrombosis was found in 6, of which there were 4 arterial and 2 venous thromboses. In 4 cases of arterial thrombosis, the circulation gradually deteriorated within 2 or 3 days and subsequent necrosis of the replanted fingertip occurred, presumably because of severe damage to the soft tissue.The overall survival rate of replantation with vein grafting was 84%.Although skillful microsurgical techniques and longer operation times are in high demand, our results using vein grafts for successful fingertip replantation are encouraging.