수지 첨부 재접합술시 출혈요법 기간의 비교 관찰

초록

To overcome venous congestion in fingertip replantation, we have used "salvage procedure" which consists of continuous external bleeding via a stab incision on paraungal area and dripping of heparinized saline solution at the incision site to maintain external bleeding. As this method requires continuous bleeding for a certain period of time, it may be a great burden for patients, therefore it is most important to minimize the duration of bleeding for patients. Many authors have studied on the new venous channel formation of the flap. However, to our knowledge a study on the new vascular connection in fingertip replantation has not yet been carried out. Between January of 1994 to August of 1999, we performed replantations for 60 fingers in 59 patients using our salvage procedure in the Korea University Guro Hospital. Among 60 cases, 49 cases were survived including partial necrosis. We reviewed medical records of these 49 cases retrospectively. We compared and analyzed the period of external bleeding according to sex, age, level, cause of amputation, and the type of injury. The average period of the salvage procedure was 8.4 days. 6.0 days was required for the patients under the age of 10, and 7.6 days for the teens, which were the shortest salvage period groups. Based on the types of injuries, it is shorter in guillotine injury group (6.9 days) than in crush (9.0 days) or avulsion (8.7 days) groups. On the other hand, the sex and level of injury did not show much difference in the duration of the procedure.

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