Replantation is a definition that includes chooped hand, foot, ear, penis or dactiles substitution. This tip parts of body can entirely chop and separate from body, or if they not chop entirely, they can be necrotic and lost because of the damage on the sustaining veins. In this case, aorta and venas are repaired by microtechnical procedures to this not entrirely chopped part get fed again.
Although replantation surgeries are very improved during the recent years, they can only succeed under the appropriate conditions. The severity, shape and place of th injury are crucial. The injuries occurred by sharp tools such as knife has more chance to be repaired because they cause less damage on the veins. In addition, in the case of splitted type of chopping called avulsion, the chance of success is low.
After the injury, time from wounding to operation and preserving conditions of the chopped part also effect the success rate of these operations. The chopped part can be preserved 6-8 hours after wounding on the best conditions. If it cannot be attached in this time, success rate decreases.
Since replantation surgery includes microsurgery, it requires experience and technical devices. In the operation, skeleton repairing of the chopped part is executed. Steel wires are usually used for this aim. Then, aortas, venas, tendons, nerves and skin are repaired. forReplantasyon cerrahisi mikrocerrahi içerdiğinden deneyim ve teknik araç-gereç gereksinimi olan bir cerrahidir. Ameliyatta öncelikle kopan parçanın iskelet onarımı sağlanır.
This operation is usually executed under general anesthesia. General anesthesia is an application that is to put patient a deep sleep and regulating his/her respiration with a tube placed in trachea by anesthesia team. To avoid a possible problem, a series of laboratory tests are executed before the surgery. The anesthetist takes te patient under rewiev before operation. In the surgery room, patient’s impulses and oxygen level in blood are checked by electronic devices throughout the operation. Rarely, reaction to medicines or allergy can occur during the surgery and they can be fatal. Besides, sensitive people cannot be detected by routine tests. However, if these undesirable situations occur under hospital conditions, they can be treated immediately and the possibility of the damage on patient decreases extremely.
Microsurgery operations are longer in comparison with others. The duration of surgery depends but it is approximately 4-8 hours. The patient is observed at recovery room for one hour after surgery, then transferred to the room. However, anesthesia-related complications such as nausea etc. can extend this time. Special medicines are applied to maintain the blood fluency in the veins stitched under microscope in the post-operation period. The medicine treatment applied to veins continues for 3-5 days. This way, coagulation in the anastomosis area is prevented since blood fluency is increased. The condition of substitutive stitched tissue is deeply observed and intervented early in any possible problem at the postoperative period. There is a second operation possibility in the operations that includes stitching veins under microscope earlier the postoperative period. When it is detected that blood fluency in the veins stops, the condition of the vein evaluated under microscope and appropriate treatment is applied. Patients who are executed by replantation operation must consider this possibility.
OTHER TREATMENT OPTIONS:
Replantation surgeries is a must for patients who have appropriate conditions. If patient’s general situation is not well, there are amputations, diabetes, hypertension or vein diseases, long-term hot ischemia, heavy contamination or physcological disorders exists, other treatment options should be considered instead of replantation. The alternative procedure for replacing of chopped part back to its place is to patch the open tissue with a suitable tissue sample.