Analysis of Anesthesia Effect of Dexmedetomidine in Clinical Operation of Replantation of Severed Finger

Brachial plexus block commonly used in finger replantation has the advantages of simple operation, small side effects, and stable circulation, but it has inherent problems such as imperfect block range, slow onset of anesthesia, and short maintenance time of anesthesia. In order to explore the reliable clinical anesthesia effect, this paper uses experimental investigation methods to study the effect of dexmedetomidine in clinical surgery of replantation of severed fingers. Moreover, this paper uses comparative test methods, uses statistical methods to process test data, and uses intuitive methods to display test results. Finally, this paper verifies the reliability of dexmedetomidine in replantation of severed finger through comparative analysis and verifies that the anesthesia method proposed in this paper has certain user satisfaction through parameter survey.

Single Digit Index Finger Amputation—To Replant or Not?

Background: Single index finger replantation is often listed as a contraindication due to its hindrance of hand function when replanted. Recent studies demonstrate comparable subjective and global functional outcomes for index flexor zone II finger replants versus revision amputations. We therefore sought to identify current opinions of plastic surgery trainees and staff treating single index finger zone II amputations including influential patient and injury characteristics. Methods: With the approval of the Canadian Society of Plastic Surgery, a 17-question survey was sent via email to all listed members on 3 separate occasions. Participation was voluntary and survey responses were compiled and analyzed using SPSS statistical software. Results: Survey response rate was 38.5%. When asked whether the surgeon would replant a single index digit, flexor zone II, sharp amputation, 55.3% of respondents chose “yes,” while 44.7% responded “no.” Staff (51.5%) were less likely to replant a single index digit amputation. Likelihood of replant dropped substantially in crush (12.4%) and avulsion (17.1%) injury. Smoking was the most likely patient characteristic to change a surgeon’s decision (61.9%). Poor range of motion (77.5%) and patient satisfaction (72.5%) were the most frequently listed reasons not to replant. Conclusion: Among Canadian plastic surgeons, there exists disagreement in how single index flexor zone II amputations should be managed. In review of the literature, these notions and previous teaching around replants highlight many inherent surgeon biases with regard to the merit and value of single digit replantation.

A Novel Grip-Type Microsurgical Needle Holder: Introduction and Electromyographic Evaluation

Background We have newly developed a novel “grip-type” gun-shaped microsurgical needle holder that requires only finger twisting between the thumb and index finger for needle advancement. This study aimed to objectively assess whether this grip-type needle holder could reduce forearm muscle movement during microsurgical suturing as compared with a conventional pen-type needle holder by means of surface electromyography (sEMG). Methods Extensor carpi ulnaris (ECU) muscle and flexor carpi ulnaris muscle (FCU) sEMG measurements were taken during needle advancement in a microvascular anastomosis model for calculation of root mean square (RMS) values. The summed ECU and FCU RMS values were employed as indicators of forearm muscle movement and compared between the pen-type and grip-type instruments. Analyses of eight subjects and suturing in five directions by one subject were conducted. Results The summed ECU and FCU RMS values of the grip-type holder were significantly smaller than those of the pen-type holder in comparisons of eight subjects (p < 0.05). Similarly, the summed RMS values of the grip-type holder in each of the five suturing directions were remarkably lower than those of the pen-type holder. Conclusion The grip-type needle holder could significantly reduce forearm muscle movement as compared with a conventional pen-type holder based on objective sEMG measurements. The grip-type device appears more ideally suited for delicate microsurgical suturing, such as lymphaticovenular anastomosis or finger replantation, since the reduced forearm movement may mitigate the risk of coarse motion and hand shaking.