ABSTRACT
ABSTRACT: Hand and upper-extremity transplantation restore severely damaged limbs that cannot be repaired with conventional surgical techniques. Over the past 20 years, more than 200 vascularized composite allotransplantations have been performed worldwide, among them 7 were cases of sex unmatched hand transplants. The long term effects of recipient sex hormones and nerve regeneration on the sexually dimorphic physical features of donor upper extremity have not been described previously. We report a case of sex congruent transformation of hand morphology in an intergender hand transplant.
Subject(s)
Hand Transplantation , Vascularized Composite Allotransplantation , Hand/surgery , Humans , Upper ExtremityABSTRACT
Until, sometime ago, microsurgery meant mainly covering a defect or replanting severed parts back to where they belong. Now, restoration of original function and aesthetic consideration is a must in planning reconstructive procedure. Hand transplant combines hand surgery and microsurgery with complex multidisciplinary care.At the anniversary of our first cadaveric bilateral proximal forearm transplantation done in the country's government institute, we would like to share our experience in performing the surgery, outcomes so far, complications, and lessons learned, to contribute to the growing knowledge of vascularized composite allotransplant.
Subject(s)
Burns, Electric/surgery , Forearm/surgery , Vascularized Composite Allotransplantation/methods , Adolescent , Amputation, Surgical , Cadaver , Humans , MaleABSTRACT
BACKGROUND & OBJECTIVE: Peripheral nerve injury is very common, but repair is a challenging medical problem. Advances in medical sciences and technologies have however made tremendous breakthroughs in understanding repair mechanisms in nerve injury making this a fascinating area in neurotherapeutics. However, a systematic analysis of existing data is lacking, the present study was attempted to review existing literature in nerve repair studies in human beings and analyse outcome systematically. METHODS: A detailed search was made from various databases published in the last 10â¯years. The studies were included based on availability of data on the age of the patients, type of injuries, type of intervention and also on the minimal follow up period. Studies satisfying these criteria were subjected to a homogeneity test. On 263 patients from 3 homogeneous studies outcome parameters such as the functional improvement, sensory and motor recovery parameters were analysed. RESULTS: Results showed that conduits were safe and significantly more effective compared to the conventional sutures in effecting repair of sensory nerve injuries (Odds ratio 3.78; Pâ¯<â¯.00001). CONCLUSION: In conclusion, repair of human sensory peripheral nerve using conduits is safe and more effective than direct nerve suture.
Subject(s)
Neurosurgical Procedures/methods , Peripheral Nerve Injuries/surgery , Peripheral Nerves/physiology , Peripheral Nerves/transplantation , Databases, Bibliographic/statistics & numerical data , Humans , Nerve Regeneration , Prostheses and Implants , Randomized Controlled Trials as TopicABSTRACT
Accessory auricles are relatively rare malformations arising from the first branchial arch which contains skin, fat and cartilage. The treatment is usually surgical removal for the cosmetic purpose. We are sharing our experience of utilising the accessory auricle skin as full thickness graft for post.burn reconstruction of the fingers contracture of a child. Even though this type of association is rare, it is an innovative idea following Sir Harold Gilles' principle 'Never throw anything away'.
