ABSTRACT
This article discusses toe-to-hand transplantation. The purpose of this article is to familiarize nurses with this procedure. In many cases, the actions taken initially and postoperatively may have a direct effect on the success or failure of the surgery. Two different procedures are discussed. The first procedure is replantation or revascularization of amputated digits in which time is of the essence and is usually performed right after the initial injury. The second procedure is the toe-to-hand transfer, which is an elective procedure in which there is less emphasis on time. This procedure occurs a few months after the initial accident.
Subject(s)
Amputation, Traumatic/surgery , Blast Injuries/surgery , Finger Injuries/surgery , Toes/transplantation , Transplantation, Autologous/methods , Transplantation, Heterotopic/methods , Adolescent , Age Distribution , Amputation, Traumatic/epidemiology , Amputation, Traumatic/psychology , Attitude to Health , Blast Injuries/epidemiology , Blast Injuries/psychology , Child , Child, Hospitalized/psychology , Finger Injuries/epidemiology , Finger Injuries/psychology , Humans , Male , Nurse's Role/psychology , Pediatric Nursing/organization & administration , Perioperative Care/methods , Perioperative Care/nursing , Perioperative Care/psychology , Physical Therapy Modalities , Replantation , Time Factors , Transplantation, Autologous/nursing , Transplantation, Autologous/psychology , Transplantation, Heterotopic/nursing , Transplantation, Heterotopic/psychology , Treatment Outcome , United States/epidemiology , Wound HealingABSTRACT
The term "extraanatomic bypass" applies to grafts that pass through a different anatomic pathway than do the natural blood vessels they replace. These grafts are devised to circumvent complex problems when conventional vascular procedures are not possible or are too hazardous to perform. There are various indications, advantages, and disadvantages to each of these grafts. Extraanatomic bypass grafts are an accepted technique with known patency rates. Quality nursing care plays a significant role in successful patient outcome.
Subject(s)
Blood Vessel Prosthesis Implantation/methods , Blood Vessels/transplantation , Ischemia/surgery , Transplantation, Heterotopic/methods , Blood Vessel Prosthesis Implantation/adverse effects , Blood Vessel Prosthesis Implantation/nursing , Humans , Ischemia/nursing , Patient Education as Topic/methods , Patient Selection , Perioperative Care/methods , Perioperative Care/nursing , Perioperative Nursing/methods , Transplantation, Heterotopic/adverse effects , Transplantation, Heterotopic/nursingABSTRACT
Microsurgical techniques have become useful in reconstructive surgery of the hand. Toe-to-thumb transplantation currently is the procedure of choice for thumb loss reconstruction. For a successful outcome, meticulous planning is imperative and presumes a thorough knowledge of the pertinent anatomy and surgical technique. The method of thumb reconstruction must be individualized and is dependent on the patient's functional needs, age, and the level of thumb amputation. Postoperatively, diligent nursing care is essential in assuring a positive outcome. Continuous communication between physicians and nurses is crucial. Astute monitoring and assessment are the core components of successful care.
