Unilateral digital arterial ligation combined with low molecular weight heparins in severed finger without venous anastomosis

Abstract

Curative effect of unilateral digital arterial ligation combined with low molecular weight heparins in the treatment of severed finger without venous anastomosis and its influence on venous crisis was studied. A total of 80 patients with distal severed finger treated in Wuxi No. 9 People's Hospital from May 2014 to July 2016 were selected into the study. According to the random number table, they were divided into the control group (n=40) and the research group (n=40). The patients in control group were treated with unilateral digital arterial ligation, while the patients in research group were treated with unilateral digital arterial ligation combined with low molecular weight heparin. The wound healing time after operation, hospitalization time, hemorheology detection results, survival rate and necrosis rate of replanted finger, incidence rate of venous crisis and recovery effect of replanted finger were compared between the two groups. After operation, the wound healing time and hospitalization time of patients in research group were lower than those in control group, and the differences were statistically significant (p<0.05). At 72 h after operation, the platelet adhesion rate, whole blood viscosity, whole blood low-shear viscosity, hematocrit and fibrinogen level in patients in research group were lower than those in control group, and the differences were statistically significant (p<0.05). At 7th day after operation, the survival rate of replanted finger in the research group was higher than that in control group, but the necrosis rate of replanted finger and incidence rate of venous crisis were lower than those in control group, and the differences were statistically significant (p<0.05). At 6 months after operation, the nail length, sensation, two-point discrimination and mobility of distal interphalangeal joint of patients in the research group were superior to those in control group, and the differences were statistically significant (p<0.05). Unilateral digital arterial ligation combined with low molecular weight heparin has a significant effect in the treatment of severed finger without venous anastomosis, which can effectively reduce or prevent the occurrence of venous crisis, improve the survival rate of replanted finger and promote the function recovery of replanted finger, so it is worthy of clinical promotion.

Keywords: curative effect; low molecular weight heparin; severed finger without venous anastomosis; unilateral digital arterial ligation; venous crisis.

Figure 1.

Surgical procedures for unilateral digital arterial ligation. (A) Remove free necrotic tissue and clean up the wound; (B) prepare the flap; (C) transfer the flap; and (D) graft free flap and suture the wound edge.

Figure 2.

Images before operation (A) and (B) after surgery.