Author/Editor     Ahčan, Uroš; Arnež, Zoran M; Trpin, Eva; Sancin, kristijan Demian
Title     Nepravilna oskrba amputiranih prstov
Translated title     Incorrent preservation of amputated digits
Type     članek
Source     Zdrav Vestn
Vol. and No.     Letnik 73, št. 9
Publication year     2004
Volume     str. 649-55
ISSN     1318-0347
Language     slo
Abstract     Background. A decision to replant is critically dependent on the condition of the amputated digit and the way it was preserved during transport. The most common error is exposing the amputated digit to very low temperatures. Preservation directly on ice, on cooling devices in portable refrigerators, or on top of packets of frozen meat often result in a frozen and therefore unusable body digit. Methods. An inquiry questionnaire on correct methods of preservation of amputated digits was conducted on a sample of 30 lay persons, 30 medical students, and 15 physicians. Three simulations of most frequently used methods of preservation of amputated digit were conducted (the correct method; directly on ice; on cooling devices of portable refrigerators). Environment temperature of the (simulated) amputated digits stored was measured. In a retrospective study, hospital records of patients treated at the Clinical department of plastic surgery and burns in Ljubljana between 1998 and 2002 were examined. We determined the number of replantations performed, gender of the patients, their age, the mechanism of the injury, the success rate of the replantation, and the duration of hospitalisation. In five case described in detail, we present an inadequate treatment of the amputated digits. Results. The results of the questionnaire survey show that no less than 86.7% of lay person respondents would have treated the injuries in an incorrect way; same holds for 43.4% students of medicine, and 33.3% of practicing physicians. The temperature of the simulated amputated digit remained above 5°C throughout the simulated correct treatment. When preserved directly on ice on or coolant bodies, the temperature dropped below the freezing point and never climbed above 0°C throughout the duration of the simulation (150 minutes). (Abstract truncated at 2000 characters).
Summary     Izhodišča. Pri odločitvi za replantacijo je pomembno stanje amputiranega prsta, kar je odvisno tudi od postopkov shranjevanja prsta med prevozom. Najpogostejša napaka je izpostavljanje amputiranega prsta prenizkim temperaturam. Shranjevanje neposredno na ledu, na hladilnih vložkih za prenosno hladilno skrinjo ali globoko zmrznjenih živilih pogosto povzroči, da prst zmrzne in je tako za replantacijo neuporaben. Metode. Opravili smo pisno anketo o pravilni oskrbi amputiranih udov pri 30 naključno izbranih laikih, 30 študentih medicine in 15 zdravnikih. Napravili smo tri simulacije najpogosteje uporabljenih metod shranjevanja amputiranega prsta (pravilen način, neposredno na ledu, na hladilnih vložkih iz hladilne skrinje) in izmerili temperaturo okolja, v katerem se nahaja amputirani prst. V retrospektivni raziskavi smo pregledali zdravstveno dokumentacijo bolnikov z amputacijskimi poškodbami v letih od 1998 do 2002, sprejetih na Klinični oddelek za plastično kirurgijo in opekline (KOPKO) Kliničnega centra v Ljubljani, opredelili smo število replantacij, delež moških oz. žensk, starost poškodovancev, mehanizem poškodbe, uspešnost replantacij in trajanje hospitalizacije. V prispevku smo opisali tudi 5 primerov z zapleti, povezanimi z nepravilno oskrbo amputiranih prstov. Rezultati. Rezultati ankete so pokazali, da bi amputirani del na napačen način oskrbelo 86,7% laične populacije, 43,4% študentov medicine in 33,3% zdravnikov. Med simulacijo pravilne oskrbe je temperatura okolja ves čas poskusa ostala nad 5°C. Neposredno na ledu in hladilnih vložkih je temperatura padla pod ledišče in se v času poskusa (150 min) ni dvignila nad 0°C. (Izvleček prekinjen pri 2000 znakih).
Descriptors     FINGER INJURIES
THUMB
AMPUTATION, TRAUMATIC
REPLANTATION
COMPUTER SIMULATION
TREATMENT OUTCOME
QUESTIONNAIRES
RETROSPECTIVE STUDIES
ORGAN PRESERVATION