Muhitdin ESKİ, Fatih ZOR, Doğan ALHAN, Selçuk IŞIK

DONMUŞ AMPUTE PARMAKLARIN REPLANTASYONU VE POSTOPERATİF YAŞANAN SIKINTILAR

Uzun süre çok düşük dereceli ısı maruziyetine bağlı olarak donmuş olan amputadların replantasyonu ile ilgili çok az sayıda yazı mevcuttur. Bu olgu sunumunda amputadlar buz paketi üzerine konularak transport süresince soğuğa direkt maruz kalmışlar ve bu nedenle donmuşlardır. Donuk amputadların replantasyonu başarılı olarak uygulanmış, ancak postoperatif dönemde donuk hasarına benzer biçimde dermal dolaşımın gecikmesine bağlı sıkıntılar yaşanmıştır. Karşılaşılan bu durum karşısında parmaklara donuk tedavisi uygulanmış ve cerrahi debridman daha sonraya bırakılmıştır. Uzun süreli takipte her iki parmağın da yaşadığı, ancak tipte parsiyel doku kaybı olduğu izlenmiştir. Bu olgu sunumunda donmuş ampute parmakların replantasyonu, tedavi yaklaşımı sunulmuş ve postoperatif dönemde yaşanan sıkıntılar tartışılmıştır.

Anahtar Kelimeler:

Donuk, replantasyon, amputasyon

REPLANTATION OF THE FROSTBITTEN AMPUTATED DIGITS AND EVENTFUL POSTOPERATIVE COURSE: CASE REPORT

Very little is written about replantation of frostbitten amputated parts due to exposure to very low temperature for extended periods. In this case report the amputated parts were placed directly on an ice pack and exposed the cold during transportation. This caused frostbite of the amputated parts. The replantation of frostbitten amputated digits was performed successfully but the postoperative course was eventful in which it was similar to that of frostbite injury including delayed dermal circulation and late vascular compromise. When these clinical manifestations were encountered frostbite treatment were applied to the digits and surgical debridement was reserved for late period. On long term follow- up both fingers were viable but resulting in partial tip tissue losses. In this case report author present replantation of frostbitten amputated digits, treatment approach and discuss the possible mechanism that cause eventful postoperative course.

Keywords:

Frostbite, replantation, amputation,

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