The favorable donor site in microsurgery: Nerve and vein graft harvest from the dorsum of the foot

2021 ◽  
pp. 1-12
Author(s):  
Carina Wenzel ◽  
Eva Brix ◽  
Paul Heidekrueger ◽  
Daniel Lonic ◽  
Philip Lamby ◽  
...  
Keyword(s):  
Cohort Study ◽  
Vein Graft ◽  
Retrospective Cohort ◽  
Injury Severity ◽  
Primary Repair ◽  
Donor Site ◽  
Hand Injury ◽  
Hand Injuries ◽  
Vein Grafts ◽  
Graft Harvest

BACKGROUND AND OBJECTIVE: In complex hand traumas nerves and vessels are often destructed without the possibility for primary repair. For bridging defects of nerves, veins and arteries grafts are necessary. Commonly nerve and vein grafts from adjacent donor sites as the wrist, forearm or cubital region are harvested. METHODS: This study is a retrospective cohort study. Between 2017 and 2019, 10 patients with complex hand injuries were treated. There were 8 males and 2 females, with an average age of 39 years (range 8–63 years). In all cases grafts were used of the dorsum of the foot for reconstructing of the severed digital nerves and arteries. All donor sites could be closed primarily. RESULTS: In 100%of cases nerves and veins of the dorsum of the foot showed a good size match as well as adequate length for a sufficient repair. The overall Hand Injury Severity Score (HISS) was determined with a median of 86 (range 57 to 286). In the area of the donor site no relevant complications were seen. CONCLUSIONS: In complex hand injuries the dorsum of the foot is a favorable donor site for nerve and vein graft harvest.

scholarly journals Predictors of increasing injury severity across suspected recurrent episodes of non-accidental trauma: a retrospective cohort study

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Jonathan Thackeray ◽  
Peter C. Minneci ◽  
Jennifer N. Cooper ◽  
Jonathan I. Groner ◽  
Katherine J. Deans
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Injury Severity ◽  
Accidental Trauma ◽  
Non Accidental Trauma

Intraoperative liposomal bupivacaine for skin graft donor site analgesia: A retrospective cohort study

Burns ◽  
2020 ◽  
Author(s):  
Christina Artz ◽  
Mark A. Ward ◽  
Majel V.P. Miles ◽  
Phillip Brennan ◽  
Kaitlin M. Alexander ◽  
...  
Keyword(s):  
Cohort Study ◽  
Skin Graft ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Donor Site ◽  
Liposomal Bupivacaine ◽  
Graft Donor

Cut-Off Value for Self-Reported Abnormal Cold Sensitivity and Predictors for Abnormality and Severity in Hand Injuries

2010 ◽  
Vol 35 (5) ◽  
pp. 409-416 ◽  
Author(s):  
I.K. Carlsson ◽  
J.Å. Nilsson ◽  
L.B. Dahlin
Keyword(s):  
Symptom Severity ◽  
Injury Severity ◽  
Hand Injury ◽  
Hand Injuries ◽  
Cold Sensitivity ◽  
Cold Intolerance ◽  
Normal People ◽  
Bone Injury ◽  
Multiple Injured ◽  
Vas Scores

Our aim was to identify a cut-off value for self-reported, abnormal cold sensitivity and to identify cold sensitivity predictors after hand injuries. The Cold Intolerance Symptom Severity (CISS) questionnaire and a VAS question concerning discomfort on exposure to cold were investigated in 94 normal people and 88 patients. A CISS score>50 was defined as abnormal cold sensitivity. Multiple injured digits, an increased number of injured vessels, complete nerve injury and replantation were variables associated with high VAS scores. Factors linked to both abnormality and worse CISS or VAS scores were: the presence of bone injury; a larger number of repaired vessels; the use of vascular grafts and a high Hand Injury Severity Score (HISS). The causes of abnormality and severity suggest a multifactorial aetiology with bony, vascular and neural components. A cut-off for abnormality is useful for descriptive, comparative and assessment purposes.

scholarly journals Effect of Earlier Door-to-CT and Door-to-Bleeding Control in Severe Blunt Trauma: A Retrospective Cohort Study

2021 ◽  
Vol 10 (7) ◽  
pp. 1522
Author(s):  
Shuhei Murao ◽  
Kazuma Yamakawa ◽  
Daijiro Kabata ◽  
Takahiro Kinoshita ◽  
Yutaka Umemura ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Outcomes ◽  
Blunt Trauma ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Injury Severity ◽  
Ct Scanning ◽  
Control Procedure ◽  
Bleeding Control ◽  
Cox Proportional Hazard Regression

Blunt trauma is a potentially life-threatening injury that requires prompt diagnostic examination and therapeutic intervention. Nevertheless, how impactful a rapid response time is on mortality or functional outcomes has not been well-investigated. This study aimed to evaluate effects of earlier door-to-computed tomography time (D2CT) and door-to-bleeding control time (D2BC) on clinical outcomes in severe blunt trauma. This was a single-center, retrospective cohort study of patients with severe blunt trauma (Injury Severity Score > 16). To assess the effect of earlier D2CT and D2BC on clinical outcomes, we conducted multivariable regression analyses with a consideration for nonlinear associations. Among 671 patients with severe blunt trauma who underwent CT scanning, 163 patients received an emergency bleeding control procedure. The median D2CT and D2BC were 19 min and 57 min, respectively. In a Cox proportional hazard regression model, earlier D2CT was not associated with improved 28-day mortality (p = 0.30), but it was significantly associated with decreased mortality from exsanguination (p = 0.003). Earlier D2BC was significantly associated with improved 28-day mortality (p = 0.026). In conclusion, earlier time to a hemostatic procedure was independently associated with decreased mortality. Meanwhile, time benefits of earlier CT examination were not observed for overall survival but were observed for decreased mortality from exsanguination.

Factors associated with survival in Adult Patients with Traumatic Arrest: A Retrospective Cohort Study from US Trauma Centers

2020 ◽  
Author(s):  
Abdel-Badih Ariss ◽  
Rana Bachir ◽  
Mazen El Sayed
Keyword(s):  
Cohort Study ◽  
Hospital Discharge ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Injury Severity ◽  
Motor Vehicle ◽  
Age Group ◽  
Trauma Centers ◽  
Level Of Evidence ◽  
Factors Associated

Abstract Background: Traumatic arrests (TA) increasingly affect young adults worldwide with low reported survival rates. This study examines factors associated with survival (to hospital discharge) in traumatic arrests transported to US trauma centers. Methods: This retrospective cohort study used the US National Trauma Databank 2015 dataset and included patients who presented to trauma centers with “no signs of life”. Univariate and bivariate analyses were done. Factors associated with survival were identified using multivariate regression analyses. Results: The study included 5,980 patients with traumatic arrests. Only 664 patients (11.1%) survived to hospital discharge. Patients were predominantly in age group 16-64 (84.6%), were mostly males (77.8%) and white (55.1%). Most were admitted to Level I (55.5%) or Level II trauma centers (31.6%). Injuries were mostly blunt (56.7%) or penetrating (39.3%). Mean ISS was 23.71 (± 20.79). Factors associated with decreased survival included: Age group ≥65 (Ref: 16-24), male gender, self-inflicted and other or undetermined types of injuries (Ref: assault), injuries to head & neck, injuries to torso and injury severity score (ISS) ≥ 16 (Ref: <16). While factors associated with increased survival included: All injury mechanisms (with the exception of Motor Vehicle Transportation (MVT)) (Ref: firearm), injuries to extremities or spine & back and all methods of coverage (Ref: self-pay).Conclusion: Patients with traumatic arrests have poor outcomes with only 11.1 % surviving to hospital discharge. Factors associated with survival in traumatic arrests were identified. These findings are important for devising injury prevention strategies and help guide trauma management protocols to improve outcomes in traumatic arrests. Level of evidence: Level III

Outcome of Hand Trauma: The Hand Injury Severity Scoring System (HISS) and Subsequent Impairment and Disability

2003 ◽  
Vol 28 (4) ◽  
pp. 295-299 ◽  
Author(s):  
A. B. MINK VAN DER MOLEN ◽  
A. M. ETTEMA ◽  
S. E. R. HOVIUS
Keyword(s):  
American Medical ◽  
Scoring System ◽  
Significant Positive Correlation ◽  
Injury Severity ◽  
Hand Injury ◽  
Hand Injuries ◽  
Hand Trauma ◽  
Severity Scoring ◽  
Total Body ◽  
Dash Questionnaire

This study was designed to evaluate correlations between the hand injury severity scoring system (HISS) and measures of impairment and disability obtained 6 months after a hand injury. A statistically significant positive correlation was found between the severity of the injury (HISS) and residual impairment, as measured with the American Medical Association’s (AMA) “Guides to the evaluation of permanent impairment, 4th edition”. No statistically significant correlation was found between the severity of the injury (HISS) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, which measures disability from the patient’s perspective. There was however a statistically significant correlation between AMA total body impairment measured and the results of the DASH questionnaire. The results indicate the potential of the HISS for predicting the final impairment after hand injuries.

Sign in / Sign up

Export Citation Format

Share Document