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J Hand Surg Asian Pac Vol ; 23(2): 232-237, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29734902

RESUMO

BACKGROUND: The success of replantation following traumatic amputation is determined by the quality of the vascular anastomoses. The purpose of this study was to assess the vascularity of injured arteries from traumatically amputated digits using arteriographic and histopathological analysis. METHODS: 25 amputated digits were included in the study. Crush and avulsion injuries were evaluated according to the Venkatramani classification. The amputated arteries were dissected under a microscope, and the arterial route determined with a transducer. Arteriography using fluoroscopy was evaluated by a radiologist. The area thought to be damaged was dissected and 2-mm slices taken for histopathological examination, and scored using the parameters of fibrin accumulation, oedema, separation, and bleeding. RESULTS: Arterial flow was observed in 6 of 7 in the avulsion group. In the crush group, arterial flow was observed in 11 of 16 cases. On histopathological examination in all cases there were 2 or more findings of either oedema, fibrin formation, bleeding or hernia. These findings were more common in the crush group then the avulsion group. CONCLUSIONS: The intravascular introduction of radio contrast agents to amputated digit prior to replantation may give further information particularly in avulsion amputations.


Assuntos
Amputação Traumática/diagnóstico por imagem , Amputação Traumática/patologia , Traumatismos dos Dedos/diagnóstico por imagem , Traumatismos dos Dedos/patologia , Dedos/irrigação sanguínea , Adulto , Angiografia , Meios de Contraste , Lesões por Esmagamento/diagnóstico por imagem , Lesões por Esmagamento/patologia , Avulsões Cutâneas/diagnóstico por imagem , Avulsões Cutâneas/patologia , Edema/patologia , Feminino , Fibrina/metabolismo , Dedos/diagnóstico por imagem , Fluoroscopia , Hemorragia/patologia , Hérnia/patologia , Humanos , Masculino , Microscopia , Pessoa de Meia-Idade , Estudos Prospectivos , Fluxo Sanguíneo Regional , Ácidos Tri-Iodobenzoicos
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