The Fate of Neglected Vascular Injury of the Hand in Acute Hand Injuries

Kim,  Tae Bum; Lee,  Yong Jig; Lee,  Young Keun; Woo,  Sang Hyun

Original Article

Journal of the Korean Society for Surgery of the Hand 2007;16(1):30-38.
Published online May 31, 2007.

The Fate of Neglected Vascular Injury of the Hand in Acute Hand Injuries

Tae-Bum Kim, M.D.*, Yong-Jig Lee, M.D., Young-Keun Lee, M.D., Sang-Hyun Woo, M.D., Ph.D.

¹Department of Plastic and Reconstructive Surgery, Dong Kang General Hospital, Ulsan, Korea.
²Woo's Institute of Hand Surgery and Reconstructive Microsurgery, Gangnam Hospital, Daegu, Korea. handwoo@hotmail.com

급성 수부 손상에서 간과된 혈관성 손상을 가진 수부의 운명

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Abstract

  In acute hand injury, there are sometimes hattened neglected or overlooked vascular injury by primary operators. The authors evaluated the final results and prognosis after secondary revascularization. In eight cases, the authors performed secondary revascularization after prolonged warm ischemia. Five fingers in five cases among them were successfully survived and three cases finally necrosed. The mean warm ischemic time was 56.1 hours. In revascularization procedures, end-toend artery anastomosis was possible in six cases. In two cases, vein graft was needed to anastomose digital artery, which resulted in complete survival of the fingers. In all three cases, revision amputation of the fingers was done. In acute complex hand injury, the importance of evaluation of the vascular injury can not be overemphasized. The necessity of the early secondary revascularization as well as serious consequence caused by misdiagnosis of vascular injury should be aware.

Key Words: Neglected vascular injury, Acute hand injury, Delayed revascularization