상지절단 환자에서 시행된 재접합술의 추적관찰 결과

서지정보

· 발행기관 : 대한혈관외과학회
· 수록지 정보 : Vascular Specialist International / 29권 / 1호 / 10 ~ 16페이지
· 저자명 : 김형기, 조자윤, 허승, 오창욱, 정호윤, 노영남, 김영욱

초록

Purpose: To report follow-up data on upper extremity (UE) macroreplantation in patients with traumatic amputation injuries. Methods: Between 1996 and 2003, 11 patients underwent UE macroreplantation at a single institution. All patients had an open fracture (n=9; upper arm, 5; forearm, 4) or an open dislocation of the elbow (n=2), combined with neurovascular and soft tissue transection injuries. The replantation procedures were performed on an emergency basis by a multi-departmental team. The mean warm ischemic time was 328 minutes (range, 165 to 480 minutes). Functional recovery of the replanted UE was evaluated with Chen's classification system, and patient satisfaction was determined using Russell's questionnaire; periodic examinations were conducted over a minimum follow-up period of 2 years. Results: Early complications consisted of 2 arterial thromboses, 1 soft tissue infection resulting in sepsis, and 1 episode of acute renal failure; UE reamputation was required in 2 patients. As a result, limb salvage was achieved in 82% of patients (9/11). A functional extremity, defined as grades I and II using Chen's criteria, was preserved in 33.3% of patients with successfully replanted limbs. Despite the objectively poor rate of function preservation, 89% of patients who had successful replantation procedures were satisfied with the results. Conclusion: Even though the functional recovery rate was low, UE macroreplantation resulted in acceptable limb salvage rates and good patient satisfaction.

참고자료

· 없음